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Sample records for vulva sparganosis misdiagnosed

  1. Vulva Anatomy

    MedlinePLUS

    ... Pictures Browse Search Quick Search Image Details Vulva Anatomy View/Download: Small: 720x634 View Download Add to My Pictures Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

  2. Pulmonary sparganosis mansoni: a case report from a non-endemic region

    PubMed Central

    Cheng, Ke-Bin; Gao, Bei-Lan; Liu, Jin-Ming

    2014-01-01

    Sparganosis mansoni is a parasitic disease caused by the larva of Spirometra mansoni. It occurs worldwide, but only a few patients show pulmonary involvement. Here, we present a case of pulmonary sparganosis mansoni in a non-endemic region. A 32-year-old Chinese woman presented with intermittent bloody phlegm, peripheral blood eosinophilia, and migratory patch shadows in both lungs. She had been misdiagnosed with eosinophilic pneumonia. She had a history of eating raw frogs, and the sparganum mansoni antibody was positive in both her blood and bronchoalveolar lavage fluid. Several sparganum mansoni were found in a frog sample that the patient provided. Consequently, she was diagnosed with pulmonary sparganosis mansoni. After two oral courses of praziquantel were administered, her symptoms and radiological lesions improved significantly. To our knowledge, this is the first case of pulmonary sparganosis mansoni occuring in Shanghai. Oral praziquantel is effective for the treatment of sparganosis mansoni, although its course of therapy may need to be repeated. PMID:24977019

  3. Angiokeratoma of vulva mimicking genital warts.

    PubMed

    Dhawan, Amit Kumar; Pandhi, Deepika; Goyal, Surbhi; Bisherwal, Kavita

    2014-12-01

    Angiokeratoma of vulva is a relatively rare lesion which is occasionally misdiagnosed as melanoma, pyogenic granuloma, seborrheic keratosis, or genital warts. We report a case of vulvar angiokeratomas which were diagnosed and managed as genital warts. All asymptomatic dull red-colored papules over vulva should be subjected to astute clinical and histological examination to diagnose angiokeratoma and differentiate it from other lesions. PMID:25404845

  4. Human sparganosis, a neglected food borne zoonosis.

    PubMed

    Liu, Quan; Li, Ming-Wei; Wang, Ze-Dong; Zhao, Guang-Hui; Zhu, Xing-Quan

    2015-10-01

    Human sparganosis is a food borne zoonosis caused by the plerocercoid larvae (spargana) of various diphyllobothroid tapeworms of the genus Spirometra. Human infections are acquired by ingesting the raw or undercooked meat of snakes or frogs, drinking untreated water, or using raw flesh in traditional poultices. More than 1600 cases of sparganosis have been documented worldwide, mostly in east and southeast Asia. Sporadic cases have been reported in South America, Europe, and Africa, and several cases have been described in travellers returning from endemic regions. Epidemiological data suggest that the increased effect of sparganosis on human health is because of greater consumption of raw meat of freshwater frogs and snakes. This Review provides information about the Spirometra parasites and their lifecycles, summarises clinical features, diagnosis, and treatment of human sparganosis, and describes geographical distribution and infection characteristics of Spirometra parasites in host animals. PMID:26364132

  5. [A case report of sparganosis mansoni in the cheek].

    PubMed

    He, Zhi-jing; Jian, Xin-chun; Wu, Xiao-shan; Huang, Hui-jing

    2008-10-01

    Sparganosis mansoni is a kind of parasitic infective disease, rarely seen in clinic. A case of sparganosis mansoni is reported in this article. The patient was a 25-year-old male, who came to Xiangya Hospital on September 26, 2007 because of a mass in the left cheek. A white tape-like body was found during the operation and recognized to be a live parasite. Enzyme linked immunosorbent assay of the serum revealed positivity against Spirometra mansoni. The final identification proved that the white tape-like body was Sparganum mansoni. The disease of this patient was caused by eating raw flesh of frogs infected with the Sparganum mansoni. PMID:19007088

  6. Surgery for Cancer of the Vulva (Vulvectomy)

    MedlinePLUS

    ... Topic Pelvic exenteration Surgery for cancer of the vulva (vulvectomy) Cancer of the vulva is sometimes treated by removing all or part of the vulva. This operation is called a vulvectomy . A partial ...

  7. Carvenous lymphangioma of the vulva

    PubMed Central

    Yoon, Kyung-Ran; Mo, A-Jin; Na, Yeon Sik; Park, Sung Taek

    2015-01-01

    Lymphangioma is a rare proliferation of the lymphatic system which is classified as either lymphangioma circumscription or carvenous lymphangioma. The involvement of the vulva is very rare and only a small number of case reports have been made on carvenous lymphangioma of the vulva. We herein report a case of 20-year-old unmarried girl presented with gradually expanding and painless tumor of the left labium majus. The mass was removed surgically and pathology confirmed as carvenous lymphangioma, with no recurrences to date. PMID:25629024

  8. Myxoid Epithelial Leiomyoma of the Vulva: A Case Report and Literature Review

    PubMed Central

    Zhao, Ting; Liu, Xishi; Lu, Yuan

    2015-01-01

    Leiomyoma of vulva is rare, and usually misdiagnosed clinically as Bartholin cyst. It usually presents spindle-shaped tumor cells, but some rare cases consisted mainly of atypical epithelioid tumor cells. We report here a case of 30-year-old woman consulting with a vulvar mass of 7?cm in the Bartholin glands area. The lesion was surgically excised with its capsule completely. Pathological examination and immunochemistry showed characteristic of epithelioid leiomyoma with myxoid stroma with both estrogen receptor (ER) and progesterone receptor (PR) staining negative, which was really rare as only 2 cases of vulvar leiomyoma with both ER and PR were reported before. PMID:26185695

  9. Nine human sparganosis cases in Thailand with molecular identification of causative parasite species.

    PubMed

    Boonyasiri, Adhiratha; Cheunsuchon, Pornsuk; Suputtamongkol, Yupin; Yamasaki, Hiroshi; Sanpool, Oranuch; Maleewong, Wanchai; Intapan, Pewpan M

    2014-08-01

    Human sparganosis is one of the neglected diseases but important food-borne parasitic zoonoses. The disease is caused by larvae (spargana) of diphyllobothriidean tapeworm. Here, we describe nine cases of human sparganosis, caused by Spirometra erinaceieuropaei in a hospital in Thailand during 2001-2012. Clinical characteristics, treatment, and outcome of cases were revealed. Diagnosis and identification of causative parasite species was made by histopathological investigations followed by a polymerase chain reaction-based molecular method using formalin-fixed paraffin embedded tissues. The DNA samples were extracted from tissues and a partial fragment of cytochrome c oxidase subunit 1 (cox1) gene was amplified for the detection of parasitic DNA. Infection could be prevented by increasing activities on health communication by responsible public health agencies. PMID:24842879

  10. Characterization of Spirometra erinaceieuropaei Plerocercoid Cysteine Protease and Potential Application for Serodiagnosis of Sparganosis

    PubMed Central

    Liu, Li Na; Wang, Zhong Quan; Zhang, Xi; Jiang, Peng; Qi, Xin; Liu, Ruo Dan; Zhang, Zi Fang; Cui, Jing

    2015-01-01

    Background Sparganosis is a neglected but important food-borne parasitic zoonosis. Clinical diagnosis of sparganosis is difficult because there are no specific manifestations. ELISA using plerocercoid crude or excretory–secretory (ES) antigens has high sensitivity but has cross-reactions with other helminthiases. The aim of this study was to characterize Spirometra erinaceieuropaei cysteine protease (SeCP) and to evaluate its potential application for serodiagnosis of sparganosis. Methodology/Principal Findings The full length SeCP gene was cloned, and recombinant SeCP (rSeCP) was expressed and purified. Western blotting showed that rSeCP was recognized by the serum of sparganum-infected mice, and anti-rSeCP serum recognized the native SeCP protein of plerocercoid crude or ES antigens. Expression of SeCP was observed at plerocercoid stages but not at the adult and egg stages. Immunolocalization identified SeCP in plerocercoid tegument and parenchymal tissue. The rSeCP had CP activity, and the optimum pH and temperature were 5.5 and 37°C, respectively. Enzymatic activity was significantly inhibited by E-64. rSeCP functions to degrade different proteins and the function was inhibited by anti-rSeCP serum and E-64. Immunization of mice with rSeCP induced Th2-predominant immune responses and anti-rSeCP antibodies had the potential capabilities to kill plerocercoids in an ADCC assay. The sensitivity of rSeCP-ELISA and ES antigen ELISA was 100% when performed on sera of patients with sparganosis. The specificity of rSeCP-ELISA and ES antigen ELISA was 98.22% (166/169) and 87.57% (148/169), respectively (P<0.05). Conclusions The rSeCP had the CP enzymatic activity and SeCP seems to be important for the survival of plerocercoids in host. The rSeCP is a potential diagnostic antigen for sparganosis. PMID:26046773

  11. Benign Tumors and Tumor-like Lesions of the Vulva.

    PubMed

    Heller, Debra S

    2015-09-01

    A variety of mass lesions may affect the vulva. These may be non-neoplastic, or represent benign or malignant neoplasms. A review of benign mass lesions and neoplasms of the vulva is presented. PMID:26125957

  12. Sparganosis in the monotremes Tachyglossus aculeatus and Ornithorhynchus anatinus in Australia.

    PubMed

    Whittington, R; Middleton, D; Spratt, D M; Muntz, F; Carmel, B; McCracken, H E; Strakosch, M R; Stephanson-Shaw, J; Harper, P A; Hartley, W J

    1992-10-01

    Sparganosis in the echidna, Tachyglossus aculeatus, is characterized by large subcutaneous masses that may be confused with neoplasms. Plerocercoids, believed to be Spirometra erinacei, were found in the ventral or lateral subcutaneous tissues of three echidnas. In each case there was a prominent fibrous mass < or = 12 cm in diameter enclosing plerocercoids, which were surrounded by an intense inflammatory infiltrate dominated by plasma cells and lymphocytes, with focal suppuration. Multiple, small (< or = 2 mm) plerocercoids were present in the lungs and pleural cavity of a fourth echidna that died due to severe pneumonitis. Several plerocercoids also were found in the lung of a platypus (Ornithorhynchus anatinus) associated with parenchymal compression and focal pneumonia. PMID:1474663

  13. Tinea capitis favosa misdiagnosed as tinea amiantacea

    PubMed Central

    Anane, Sonia; Chtourou, Olfa

    2012-01-01

    Introduction Favus of the scalp or tinea capitis favosa is a chronic dermatophyte infection of the scalp. In almost cases, favus is caused by Trichophyton schoenleinii, anthropophilic dermatophyte. It is characterized by the presence of scutula and severe alopecia. Besides the classic clinical type of tinea capitis favosa, there are many variant of clinical form which may persist undiagnosed for many years. In this work, we report an atypical form of favus to Trichophyton schoenleinii which was misdiagnosed as tinea amiantacea. Case-report An 11-year old girl came to the outpatient department of dermatology (day 0) with history of tinea amiantacea treated unsuccessfully with keratolytic shampoo (day – 730). She presented a diffuse scaling of the scalp with thick scaly patches and without scutula or alopecia. A diagnosis of tinea favosa by T. schoenleinii was made by mycological examination. She was treated with griseofulvin and ketoconazole in the form of foaming gel for twelve weeks. Despite treatment, clinical evolution was marked by appearance of permanent alopecia patches. The follow-up mycological examination was negative. Conclusion Because of ultimate evolution of favus into alopecia, we emphasize the importance of mycological examination in case of diffuse scaling. PMID:24432210

  14. Morphogenesis of the C. elegans vulva

    PubMed Central

    Schindler, Adam J

    2012-01-01

    Understanding how cells move, change shape, and alter cellular behaviors to form organs, a process termed morphogenesis, is one of the great challenges of developmental biology. Formation of the C. elegans vulva is a powerful, simple, and experimentally accessible model for elucidating how morphogenetic processes produce an organ. In the first step of vulval development, three epithelial precursor cells divide and differentiate to generate 22 cells of seven different vulval subtypes. The 22 vulval cells then rearrange from a linear array into a tube, with each of the seven cell types undergoing characteristic morphogenetic behaviours that construct the vulva. Vulval morphogenesis entails many of the same cellular activities that underlie organogenesis and tissue formation across species, including invagination, lumen formation, oriented cell divisions, cell-cell adhesion, cell migration, cell fusion, extracellular matrix remodelling and cell invasion. Studies of vulval development have led to pioneering discoveries in a number of these processes and are beginning to bridge the gap between the pathways that specify cells and their connections to morphogenetic behaviors. The simplicity of the vulva and the experimental tools available in C. elegans will continue to make vulval morphogenesis a powerful paradigm to further our understanding of the largely mysterious mechanisms that build tissues and organs. PMID:23418408

  15. Surgical removal of a live worm by stereotactic targeting in cerebral sparganosis. Case report.

    PubMed

    Nobayashi, Misato; Hirabayashi, Hidehiro; Sakaki, Toshisuke; Nishimura, Fumihiko; Fukui, Hiroshi; Ishizaka, Shigeaki; Yoshikawa, Masahide

    2006-03-01

    A 64-year-old man presented with generalized tonic clonic convulsion followed by weakness of the right lower extremity. He had a medical history of hypertension, hyperlipidemia, and right cerebellar infarction. Computed tomography (CT) showed a small high density nodule with an enhanced perifocal low density area in the left occipital lobe. T1-weighted magnetic resonance (MR) imaging showed a ring-shaped and partial string-like nodule with enhancement by gadolinium. T2-weighted MR imaging showed the white matter of the left occipital lobe as high intensity. CT and MR imaging seemed to indicate metastatic brain tumors, although cortical atrophy and ventricular dilation were recognized. Left parietal craniotomy was performed under stereotactic targeting to obtain a definitive diagnosis. During manipulation at the center of the targeted lesion, a white, tape-like body was found and recognized to be a live worm. Serological testing revealed strong immunopositivity against Spirometra mansoni. The infection route in the present case was probably through eating raw chicken meat. Cerebral sparganosis is extremely rare but should be considered in the differential diagnosis of metastatic brain tumors, especially in endemic areas. PMID:16565589

  16. Cáncer de vulva—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. [Human sparganosis. Report of a probable 7th case in South America and review of the subject].

    PubMed

    Rolón, P A

    1976-01-01

    A case of human Sparganosis was found in a resident of Northern Argentina, Pozo del Tigre, Province of Formosa, a zone bordering with the Republic of Paraguay, with a histopathologic diagnosis realized in the Pathologic Anatomy Institute of Asunción. In the Republic of Paraguay Dyphyllobrotium has been observed in cats, which reveals the existence of intermediaries (rats, water snakes, birds, etc.) as sources of human infection. Northern Argentina, where the patient always lived, is a geographic zone similar to the Republic of Paraguay. This case is the first described in the inland zone of the continent (and probably the seventh case in the Southamerican continent). The patient's profession, called "tropero" (cowherd), required that he had close contact with the land or a habitual exposure to nature, which does not exclude the probability of infection related to the patient's professional habitat. PMID:1037439

  18. The Endemic Mimic: Blastomycosis An Illness Often Misdiagnosed

    PubMed Central

    Bradsher, Robert W.

    2014-01-01

    One of the endemic fungi, Blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. Blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lung. Extrapulmonary infection with B. dermatitidis is protean with many different manifestations. Most commonly, skin or subcutaneous lesions are found with either a verrucous or warty appearance or in an ulcerative form. Cases have been misidentified as keratoacanthoma, pyoderma gangrenosum, carcinoma, or as Weber-Christian panniculitis if there are nodular subcutaneous lesions. Essentially any site or organ can have lesions of disseminated blastomycosis. In our series, cases of laryngeal carcinoma, adrenal insufficiency, thyroid nodules, granulomatous hypercalcemia, abnormal mammograms thought to represent breast carcinoma, otitis media with cranial extension, immune thrombocytopenic purpura, and hemolytic anemia of unknown cause have been misdiagnosed and blastomycosis subsequently identified as the cause. This infection causes manifestations which mimic many other more commonly diagnosed conditions and must always be considered by clinicians practicing in the endemic region. PMID:25125734

  19. GIANT AGGRESSIVE ANGIOMYXOMA OF THE VULVA: CASE REPORT.

    PubMed

    Fatuši?, Jasenko; Hudi?, Igor; Fatuši?, Zlatan; ?i?kuši?, Elmir; Šarkanovi?, Goran

    2015-06-01

    A 57-year-old multiparous housewife was hospitalized at University Clinical Center with painless, ulcerated, huge tumor of the vulva, which had progressively increased in size during the last five years. It was a firm, ulcerated mass involving the left vulva and measuring 35 cm in diameter. The vaginal orifice was deviated to the right by the tumor. The adnexa and the uterus were normal. The patient underwent total excision of the tumor in general anesthesia, and histology confirmed aggressive angiomyxoma. She had an uneventful postoperative period with satisfactory healing of the wound. PMID:26415320

  20. The Normal Vulva, Vulvar Examination, and Evaluation Tools.

    PubMed

    Cohen Sacher, Bina

    2015-09-01

    The appearance of the female external genitalia is key for understanding and diagnosing many diseases that women of all ages encounter. Alas, the normal appearance of the vulva is an elusive concept, scarcely represented in textbooks, and the growing number of vulvar cosmetic surgery calls for a review of the normal appearance of the vulva and its diversity. In this paper I will review vulvar embryology, anatomy, the current literature discussing vulvar appearance, and describe meticulous vulvar examination, including the diagnostic tools. PMID:26083130

  1. Extraskeletal myxoid chondrosarcoma of the vulva: A case report

    PubMed Central

    VILLERT, ALISA; KOLOMIETS, LARISA; VASILYEV, NIKOLAY; PERELMUTER, VLADIMIR; SAVENKOVA, OLGA

    2015-01-01

    Extraskeletal myxoid chondrosarcoma (ESMC) of the vulva is an extremely rare tumor and currently, there is little available information on its biological behavior and treatment strategy. The present study reports a case of recurrent ESMC of the vulva in a 32-year-old female. The patient presented with an increasingly painful mass of the right vulva, at the site of an exision which had been performed 7-months previously. The tumor mass was histopathologically diagnosed as primary ESMC of the vulva and subsequently, vulvectomy was performed. Cytological examination showed negative surgical margins. Intraoperative radiation therapy at a single dose of 10 Gy was administered to the bed of the removed tumor. The patient refused chemotherapy and five months after surgery, a new lesion was identified in the inguinal region. Bilateral inguinal-femoral lymph node dissection was performed and external beam radiation therapy at a dose of 40 Gy was administered to the inguinal region. Follow-up examination seven months after surgery revealed no evidence of disease progression and at present, the patient remains alive. This study highlights the importance of analyzing each clinical case of ESMC as this may lead to the development of guidelines for the optimal treatment of this rare tumor. PMID:26622802

  2. Misdiagnosing Absent Pedicle of Cervical Spine in the Acute Trauma Setting

    PubMed Central

    Rossel, Felipe; Nooh, Anas; Jarzem, Peter

    2015-01-01

    Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT)-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms. PMID:26605026

  3. Non-leukemic myeloid sarcoma involving the vulva, vagina, and cervix: a case report and literature review

    PubMed Central

    Yu, Yuan; Qin, Xuemei; Yan, Shuxin; Wang, Wenxia; Sun, Yanlin; Zhang, Maohong

    2015-01-01

    Myeloid sarcoma (MS) is defined as a tumor mass consisting of myeloid blast with or without maturation occurring at an anatomical site other than bone marrow with normal architectural effacement. It can also precede the onset of leukemia which is called non-leukemic MS. Non-leukemic MS is a kind of rare disease and easy to be misdiagnosed as other common malignancies due to the rarity and nonspecific manifestation. We herein report an unusual case of non-leukemic MS involving the vulva, vagina, and cervix in a female patient. The bone marrow aspiration and biopsy of the patient revealed no hematological abnormality. Immunohistochemical staining of the biopsies was strongly positive for myeloperoxidase, CD68, leukocyte common antigen (LCA), CD117, CD34, CD38, CD79a, and negative for cytokeratin (CK), epithelial memberane antigen (EMA), CD2, CD3, CD20, CD5, CD138. Then a diagnosis of non-leukemic MS was made. Unfortunately, our patient received only one cycle of chemotherapy consisting of cytosine arabinoside and daunorubicin, then refused any further treatment and died 4 months after diagnosis. Although systemic chemotherapy is widely accepted to be a promising strategy, its benefit still needs to be further assessed. Certain questions still need to be answered for this disease: 1) Why can approximately 20% of the patients with non-leukemic MS remain disease-free after local therapy alone? 2) How many cycles of chemotherapy are needed for these patients after achievement of complete remission? 3) What are the prognostic or risk factors in these patients who have no abnormality of karyotype, fusion genes, or gene mutation to predict responsiveness to chemotherapy and outcome? 4) What is the risk factor for relapse? The rarity of non-leukemic MS makes it almost impossible to conduct large-scale randomized trials, but judicious study for each patient with MS is helpful for a further understanding of the nature of the disease. PMID:26677338

  4. Aneurysmal Bone Cyst of Sphenoid Bone and Clivus Misdiagnosed as Chordoma: A Case Report

    PubMed Central

    Samanci, Cesur; Asik, Murat; Yanik, Inanc; Ozkanli, Seyma; Tutar, Onur; Hasiloglu, Zehra Isik

    2015-01-01

    Aneurysmal bone cysts (ABCs) are benign and rapidly expanding bone destructive lesions of any bone. They are commonly localized in the metaphysis of long bones, whereas skull base ABCs are rare. We report a case of a 21-year-old man who had been misdiagnosed as chordoma and undergone surgery. However, histopathological examination revealed it to be an ABC. PMID:26605267

  5. Paget's Disease of the Vulva in Premenopausal Woman Treated with Only Surgery: A Case Report

    PubMed Central

    Asmouki, Hamid; Oumouloud, Rachid; Aboulfalah, Abderrahim; Soummani, Abderraouf; Marrat, Abdelouahed

    2012-01-01

    Paget's disease of the vulva remains a rare condition with only a limited number of cases reported in the literature. It is an uncommon neoplasm usually of postmenopausal white women characterized by controversies in its prevalence, clinical features, treatment strategies, and prognostic. We here report a case of a primary Paget's disease of the vulva in premenopausal woman treated by only surgery with a favorable issue. PMID:23024871

  6. A misdiagnosed melanoma: a case of cutaneous epithelioid malignant peripheral nerve sheath tumor.

    PubMed

    Linos, Konstantinos; Warren, Simon

    2015-04-01

    Malignant Peripheral Nerve Sheath Tumor (MPNST) is a rare soft tissue sarcoma that can occur in superficial locations. Histologically it is categorized into two variants: a conventional/spindled and an epithelioid variant. The latter one is very rare and can be confused histologically with malignant melanoma as it is diffusely positive for S100-protein. Herein we present a case that was initially misdiagnosed as malignant melanoma and discuss morphological and immunohistochemical clues to reach a correct diagnosis. PMID:25933073

  7. Paget Disease of the Vulva: Diagnosis by Immunohistochemistry

    PubMed Central

    Gonçalves Amorim, Andressa; Batista Fraga Mendes, Brunelle; Neves Ferreira, Rodrigo; Chambô Filho, Antônio

    2015-01-01

    The objective of this paper is to report a case of extramammary Paget disease of the vulva, to describe its diagnosis, surgical treatment, and outcome, and to discuss the general characteristics of this pathology. This is a rare neoplasm, found principally in areas in which apocrine and eccrine glands are numerous. This case report is relevant to the literature since the differential diagnosis of extramammary Paget disease is difficult to be done only with the macroscopic appearance of the lesion and even with the microscopic characteristics, requiring further studies, immunohistochemistry, as to differentiate pathologies. The present report describes the case of a 63-year-old patient at the Santa Casa de Misericórdia Hospital in Vitória, Espírito Santo, Brazil, who presented with a hardened, ulcerated, and purplish lesion with hyperchromic and hypochromic spots, measuring 4?cm in diameter, located on the lower third of right labium majus, close to the vaginal fourchette. A right hemivulvectomy was performed, leaving wide margins all around. The patient progressed satisfactorily following surgery. Although extramammary Paget disease is rare, its incidence increases as a function of the patient's age. Patients should be followed up closely because of the risk of persistence and/or recurrence of the disease. PMID:26060586

  8. Angiomyofibroblastoma of the vulva: report of a case.

    PubMed

    Tochika, N; Takeshita, A; Sonobe, H; Matsumoto, M; Kobayashi, M; Araki, K

    2001-01-01

    A 45-year-old woman was first seen by us 2 years after becoming aware of a slightly painful subcutaneous mass in her left vulva. The mass was 7.5 x 3.0 cm in size, well circumscribed, mobile, and rubbery. It was at first clinically considered to be a benign tumor. Microscopically, the resected mass was composed of spindle or polygonal tumor cells which were cellularly or hypocellularly arranged with perivascular accentuation in a mucoid or fibrocollagenous background. Immunohistochemically, myxoid tumor cells were positive for vimentin but not for alpha-smooth muscle actin, CD34, CD31, desmin, or S-100 protein. The tumor was diagnosed as an angiomyofibroblastoma (AMBF), based on the typical findings of histology and immunohistochemistry. There are many histological types of vulvar tumors, and establishing a preoperative diagnosis is difficult in many patients. Rapid intraoperative pathological diagnosis should be performed if possible, considering the possibility of diseases such as AMFB and aggressive angiomyxoma (AAM). When AAM is suspected, the peripheral tissues should also be resected to prevent recurrence. PMID:11428615

  9. Angiomyofibroblastoma of the vulva: a mitotically active variant?

    PubMed

    Takeshima, Y; Shinkoh, Y; Inai, K

    1998-04-01

    A case of angiomyofibroblastoma in a 48-year-old woman is reported. The tumor occurred as a left vulval mass and was treated by simple excision. It was located in the subcutaneous tissue of the left vulva and was well circumscribed, measuring 2.8 x 2.7 x 2.5 cm. Microscopically, the tumor was composed of hypocellular and cellular areas with well-developed small vessels. Spindle or polygonal cells were arranged with perivascular accentuation in an edematous or fibrocollagenous background. Some spindle-shaped or polygonal stromal cells were also arranged in epithelioid nests. In some areas, mitoses were frequent (maximum 3/10 high-power field). Immunohistochemically, the stromal cells were positive for vimentin and desmin, but negative for alpha-smooth muscle actin, S-100, neurofilament, estrogen receptor, progesterone receptor, CD31 and CD34. The average labeling index of Ki-67 in stromal cells was 3.1%. Ultrastructural analysis demonstrated that the stromal cells adhered with primitive junctions and contained intermediate filaments with no focal density in the cytoplasm. These findings were consistent with angiomyofibroblastoma, although previously reported cases did not show so many mitoses. Therefore, this case was suggested to be a mitotically active variant. PMID:9648158

  10. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct

    PubMed Central

    Gu, Dae Hoe; Park, Min Seon; Jung, Chang Ho; Yoo, Yang Jae; Cho, Jae Young; Lee, Yun Ho; Yim, Hyung Joon; Um, Soon Ho; Ryu, Ho Sang

    2015-01-01

    Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy. PMID:26157755

  11. Gastric Schwannoma: A Benign Tumor Often Misdiagnosed as Gastrointestinal Stromal Tumor

    PubMed Central

    Rathi, Pravin M.; Somani, Vaibhav S.; Mulani, Astha M.

    2015-01-01

    Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma. PMID:26664714

  12. Central Serous Chorioretinopathy Misdiagnosed as Posterior Uveitis and the Vicious Circle of Corticosteroid Therapy

    PubMed Central

    Papadia, Marina; Jeannin, Bruno; Herbort, Carl P.

    2015-01-01

    Purpose: To determine the proportion of patients with central serous chorioretinopathy (CSCR) mistaken for posterior uveitis and to identify the deleterious consequences. Methods: Charts of 1,657 patients admitted in the section of inflammatory eye diseases at the Center for Ophthalmic Specialized Care (COS) in Lausanne, Switzerland from 1995 to 2013 were reviewed. CSCR cases misdiagnosed as posterior uveitis or those with superimposed disease due to steroid therapy for uveitis were studied. Delay in diagnosis, specific erroneous uveitis diagnosis and evolution of the disease were also evaluated. Retrospectively, the most useful means for a correct diagnosis of CSCR were the original fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) when available. Results: Out of a total of 1,657 patients, 15 (0.9%) cases with CSCR were identified. These included 12 subjects misdiagnosed as posterior uveitis and 3 uveitis subjects with superimposed CSCR following corticosteroid therapy for uveitis. The presentation of the disease was largely influenced by improper and continued use of corticosteroids. Conclusion: CSCR is a rare but not negligible misdiagnosis in posterior uveitis representing approximately 1% of subjects from a collective series of uveitis cases at a referral center. Investigative measures such as FA, ICGA and OCT are crucial for reaching a correct diagnosis and avoiding disease aggravation due to corticosteroid therapy.

  13. Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

    PubMed Central

    Ventolini, Gary; Patel, Ravi; Vasquez, Robert

    2015-01-01

    Objective Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. PMID:26056492

  14. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    PubMed Central

    Yin, Fu-Fen; Wang, Ning; Wang, You-Lin; Bi, Xiao-Ning; Xu, Xiao-Hui; Wang, Yan-Kui

    2015-01-01

    Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy. PMID:26693368

  15. Cherubism misdiagnosed as giant cell tumor: a case report and review of literature

    PubMed Central

    Jiao, Yang; Zhou, Mi; Yang, Yaowu; Zhou, Jun; Duan, Xiaohong

    2015-01-01

    Cherubism is characterized by progressive, painless, bilateral enlargement of the mandible and/or maxilla resulting from the replacement of bone with multilocular cysts composed of fibrotic stromal cells and osteoclast-like cells. Here we report one Chinese cherubism case that has been misdiagnosed for more than forty years. The patient displayed no typical clinical or radiographical signs of cherubism due to multi-surgical treatments. Her histopathologic examination revealed the proliferating fibrous connective tissue with few multinucleated giant cells. The family history suggested us to perform sequence analysis of the SH3BP2 gene, a candidate marker for cherubism, in the family, and it was found that both the proband and the son had a missense mutation in SH3BP2 in exon 9 (p. Arg415Gln). Here we emphasize the importance of gene testing in the diagnosis of suspected cherubism, especially for those cases with non-typical clinical, radiographic and histological presentations. PMID:26064398

  16. Nematode Tango Milonguero - the C. elegans male's search for the hermaphrodite vulva.

    PubMed

    Sherlekar, Amrita L; Lints, Robyn

    2014-09-01

    The vulva search corresponds to the first step of mating in Caenorhabditis elegans wherein the male recognizes a potential mate through contact and commences a systematic, contact-based search of her surface for the vulva. During this 'dance' the male presses his tail genitalia firmly against the hermaphrodite surface and moves backward, modulating tail posture to effect changes in search trajectory. Upon sensing the vulva, the male pauses and the insemination phase of mating begins. External tail sensilla, the rays, induce and guide the male's search by registering hermaphrodite surface cues. C. elegans male mating behavior, like many other animate interactions (such as predator-prey interactions or intrasexual aggression), is performed at close quarters and requires that participants constantly adjust their movement with respect to one another on a moment-by-moment basis. The design features of the supporting circuitry explain simultaneously the robustness, speed and acuity of the male's behavior and its male-specific nature. Processing at all levels of the circuitry appears to be distributed. Cellular components exhibit both partial redundancy (thus conferring robustness in output) and subtle functional differences (predicted to confer acuity). Surprisingly, gender-shared cell types feature prominently in the circuitry. Male-specific components form sensory pathways that render downstream gender-shared circuits responsive to mate cues, while other male cells act to augment gender-shared cell activity. Overall, the attributes of the vulva search circuitry provide insight into principles guiding the design and operation of circuits supporting dynamic social behaviors expressed by more complex and less tractable animal species. PMID:24862858

  17. Squamous cell carcinoma of the vulva in a virgin patient with Turner syndrome

    PubMed Central

    Topcu, Onur; Gungor, Tayfun; Ozdal, Bulent; Sirvan, Levent; Yesilyurt, Ahmet

    2011-01-01

    Two types of gynecologic tumors are commonly described in the Turner syndrome, the first one is gonadoblastoma, which occurs in patients with Y chromosome abnormalities, and the second one is endometrial carcinoma which is mostly related with exogenous estrogen usage. Here, we describe an extremely rare case of squamous cell carcinoma of the vulva in a virgin woman with Turner syndrome. A 35-years old single, virgin woman referred to our Oncology Department with warty, necrotized, exophytic 6-7 cm vulvar mass. She had a history of primary amenorrhea and mosaic Turner syndrome was determined in her karyotype analysis. Biopsy specimen of the vulvar mass revealed squamous cell carcinoma of the vulva, and total vulvectomy with inguinal femoral lymphadenectomy was performed. The postoperative course was uneventful and there has been no recurrence of the disease up to date. Women with Turner syndrome have streak ovaries that produce very low estrogen and the squamous cell carcinoma of the vulva may have developed at an early age with Turner syndrome because of this low estrogen value similar to postmenopausal women. The current case is a special case due to its age of occurrence, virgin and Turner syndrome status. PMID:21998766

  18. Case report of narcolepsy in a six-year-old child initially misdiagnosed as atypical epilepsy

    PubMed Central

    ZHOU, Jinquan; ZHANG, Xi; DONG, Zaiwen

    2014-01-01

    Summary This report describes a case of first-onset narcolepsy in a six-year-old female that was misdiagnosed as atypical epilepsy and other diagnoses at eight different hospitals over a period of 10 months before the correct diagnosis was made. The diagnosis of narcolepsy is more difficult in children because very few of them experience all four cardinal symptoms of narcolepsy – paroxysmal sleep, cataplexy, hypnagogic hallucination, and sleep paralysis – and they often have a more prolonged onset and diverse symptoms. To decrease the time lag between initial presentation and accurate diagnosis, we recommend that in all cases in which children report excessive sleep of unknown etiology – regardless of the associated symptoms – that sleep monitoring and sleep latency tests be conducted to rule out the possibility of narcolepsy. The case highlights the wide variety of presentations of uncommon psychiatric conditions, particularly in children, and the need for clinicians to be aware of the atypical presentations of these conditions when collecting medical histories. PMID:25317010

  19. FIGO stage IV gestational choriocarcinoma misdiagnosed as pulmonary tuberculosis: A case report

    PubMed Central

    YANG, LINGYUN; XU, PANG; XI, MINGRONG; WANG, HONGJING

    2015-01-01

    Choriocarcinoma is a rare, highly malignant neoplasm, which may occur during or following any type of pregnancy. This tumor often demonstrates rapid hematogenous spread to multiple organs, and is associated with high human chorionic gonadotropin (HCG) levels and a good response to chemotherapy. In the present study, the case of a 29-year-old female with distant metastatic choriocarcinoma [International Federation of Gynecology and Obstetrics (FIGO) stage IV; World Health Organization score, 15], who was misdiagnosed with pulmonary tuberculosis at a local hospital is presented. The major failure in the diagnosis of this case was that the patient's serum ?-HCG levels were ignored initially. However, the patient received combined treatment with systematic multi-agent chemotherapy, whole-brain radiation therapy and gross total resection of the brain lesion at West China Second Hospital, and achieved complete remission. In conclusion, the accurate and prompt diagnosis of choriocarcinoma is crucial for a good outcome. Furthermore, in young female patients exhibiting symptoms such as pulmonary bleeding or neurological disturbances following a hydatidiform mole or a normal pregnancy, even in the absence of abnormal uterine bleeding, serum ?-HCG levels must be analyzed and a diagnosis of choriocarcinoma must be considered. PMID:26622776

  20. Metastatic uterine leiomyosarcoma in the upper buccal gingiva misdiagnosed as an epulis.

    PubMed

    Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

    2014-01-01

    Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, "local" relapse was observed 5 months after surgery. PMID:25386373

  1. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    PubMed Central

    Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

    2014-01-01

    Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery. PMID:25386373

  2. Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses

    PubMed Central

    2013-01-01

    Background Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic. Findings The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained. Conclusions As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater. PMID:24020375

  3. "Light cupula" involving all three semicircular canals: A frequently misdiagnosed disorder.

    PubMed

    Kim, Chang-Hee; Shin, Jung Eun; Shin, Dong Hyuk; Kim, Yong Won; Ban, Jae Ho

    2014-11-01

    Though benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder causing positional vertigo, patients with typical positional vertigo in which the findings of positional nystagmus do not meet the diagnostic criteria for BPPV are often encountered in the clinic. Recently a concept of the light cupula was introduced, which accounts for some of positional vertigo. Under a normal condition in which the specific gravity of the cupula is same as that of the surrounding endolymph, semicircular canals (SCCs) are not influenced by the gravity. The light cupula, which indicates cupula with lower specific gravity than the surrounding endolymph, is characterized by persistent geotropic direction-changing positional nystagmus (DCPN) without latency on the supine head-roll test and the presence of a null plane. Unless the duration and pattern of positional nystagmus are carefully examined, the light cupula can be misdiagnosed as other types of BPPV. We present a patient with light cupula on the right side who reported recurrent episodes of positional vertigo and had been diagnosed as BPPV with multiple canal involvement (posterior and lateral SCCs) on the opposite side. In this study, we present the mechanism of typical positional nystagmus patterns in patients with light cupula involving all of the unilateral SCCs, and discuss the possible causes of misdiagnosis of the light cupula. PMID:25249441

  4. Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review

    PubMed Central

    ZHENG, YAN; JIA, JINJING; TIAN, QIONG; DONG, XINYU; WANG, XIN; YING, ZHAOXIA; XIAO, SHENGXIANG; LI, WENSHENG

    2014-01-01

    The aim of this study was to improve the level of diagnosis and differential diagnosis of lymphomatoid papulosis (LyP). Two cases of type B LyP were identified and the literature was reviewed to summarize the clinical outcomes and pathology of LyP and its treatment. The two patients exhibited symptoms with papulonodular lesions, the centers of which gradually underwent ulceration and necrosis. CD30, a helper T-cell marker specifically expressed in tumor cells was analyzed by immunohistochemical staining and the result showed that CD30-negative or only scattered CD30-positive cells were present. Therefore, a diagnosis of type B LyP was made. A fairly good curative effect was achieved following treatment with retinoic acid, glucocorticoids and immunomodulatory drugs. LyP is a type of low-level malignant lymphoma and is easily misdiagnosed as pityriasis lichenoides et varioliformis acuta and other diseases. In order to avoid under diagnosis and misdiagnosis, doctors should evaluate suspected patients by histopathological and immunohistochemical examination. PMID:25371758

  5. Fetal t(5p;21q) misdiagnosed as monosomy 21: A plea for in situ hybridization studies

    SciTech Connect

    Gill, P.; Uhrich, S.; Cheng, E.; Disteche, C.

    1994-10-01

    We report a case of 45,XY,-5,-21,+der (5)t(5;21) (p13 or p14;q11.2 or q21) that was prenatally misdiagnosed as complete monosomy 21 and terminated at 24 weeks of gestation. Subsequent fluorescence in situ hybridization studies with a chromosome 21 painting probe documented the cryptic unbalanced translocation. 17 refs., 2 figs., 1 tab.

  6. Family history unawareness of blood clot risk: links to misdiagnoses and illness uncertainties in personal and expert realms.

    PubMed

    Parrott, Roxanne; Hong, Soo Jung; Greenberg, Marisa

    2015-01-01

    The difficulty of diagnosing blood clots makes salient the question, "What role does family history awareness have for guiding lay and expert actions?" The authors examine the in-depth life reflection interviews of 20 women who experienced a first venous blood clot between the ages of 18 and 50 years, identifying causal attributions the women made for thrombosis after the event. Twelve participants described an understanding of the cascade of events linked to thrombosis, revealing that there is seldom a single cause. The other eight identified belief in a single determining cause for their thrombosis. The authors reflect on the symptoms the women experienced during the course of the clotting event, patterns of care that they executed to self-manage their blood clot, and their misdiagnoses associated with symptoms and care. The women recalled the patterns of care received through formal health care systems and the reported misdiagnoses linked to these interactions. The recollections reveal that the subtle nature of venous blood clot symptoms contributes to lay and expert misdiagnoses. Use of antibiotics and pain killers in the wake of misdiagnosis masks symptoms, contributing to costly delays in accurate diagnoses. Four women were aware of a family history of clotting when the event occurred, 13 had such a history but lacked awareness until the clotting event, and three had no known history. Among women with awareness of their family history, blood clot diagnosis occurred sooner, promoting survival and efficiencies in health care. Implications for communicating about family history of thrombosis are considered. PMID:24794077

  7. Genital Anxiety and the Quest for the Perfect Vulva: A Feminist Analysis of Female Genital Cosmetic Surgery

    E-print Network

    Chen, Zhongping

    Cosmetic Surgery Ariana Keil 95863710 Women and the Body- Professor Susan Greenhalgh UCI March, 2010 #12;2 Genital Anxiety and the Quest for the Perfect Vulva: A Feminist Analysis of Female Genital Cosmetic Surgery Female genital cosmetic surgery procedures are relatively new, but they are swiftly growing

  8. Laser therapy as the method of choice in treating young women with CIN lesions of the uterine cervix and VIN lesions of the vulva

    NASA Astrophysics Data System (ADS)

    Knapp, Piotr A.

    1996-03-01

    The aim of the studies was to attempt to investigate the results of treating young women with CIN I - III of the cervix and epithelial VIN I - III lesions of the vulva by means of the laser technique (vaporization).

  9. Cancer - vulva

    MedlinePLUS

    ... girls before they become sexually active, and to adolescents and women up to age 26. Routine pelvic exams can help diagnose vulvar cancer at an earlier stage. Earlier diagnosis improves your chances that treatment will be successful.

  10. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers

    USGS Publications Warehouse

    Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore, Jr.; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

    2015-01-01

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

  11. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?

    PubMed Central

    Rodríguez, Verónica Garza; De la Fuente García, Alberto; Torres, Myrna Alejandra Cardoza; Flores, Minerva Gómez; Moreno, Gildardo Jaramillo; Candiani, Jorge Ocampo

    2014-01-01

    Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed. PMID:24860751

  12. A rare case of extrafollicular adenomatoid odontogenic tumour in the posterior region of the mandible: misdiagnosed as residual cyst.

    PubMed

    Shivali, Vaid; Pandey, Anil; Khanna, Vidhi D; Khanna, Prateek; Singh, Ashish; Ahuja, Tarun

    2013-10-01

    Adenomatoid odontogenic tumor is a relatively uncommon distinct odontogenic neoplasm. It is an uncommon tumor of odontogenic origin with varying number of ductlike structures and inductive changes in the stroma. It is a benign and slow growing epithelial tumor and represents 3% of all odontogenic tumors. Its occurrence is more common in anterior region of the maxilla than mandible. Most of the adenomatoid odontogenic tumors occur intra-osseously but few peripheral variant have been reported which are attached to the gingival structures. The intra-osseous Adenomatoid odontogenic tumor may be related to unerrupted tooth (follicular varient) or may not (extrafollicular varient) be related to unerrupted tooth. This paper is to present a rare case of an extrafollicular Adenomatoid odontogenic tumor occurring in the body of the mandible in a male patient which is distinct and secondly it was clinically and radiographically diagnosed as residual cyst. The diagnosis of Adenomatoid odontogenic tumor was confirmed by Histopathological investigation. How to cite this article: Shivali V, Khanna VD, Khanna P, Singh A, Pandey A, Ahuja T. A Rare Case of Extrafollicular Adenomatoid Odontogenic Tumour in the Posterior Region of the Mandible: Misdiagnosed as Residual Cyst. J Int Oral Health 2013; 5(5):124-8. PMID:24324316

  13. Sebaceous hyperplasia of the vulva: a series of cases reporting no association with the Muir-Torre syndrome.

    PubMed

    Roma, Andres A; Barry, Jessica; Pai, Rish K; Billings, Steven D

    2014-07-01

    Sebaceous gland hyperplasia is a common skin condition, very rarely reported in the female genital region. We present 13 cases from 12 patients, the first case series of sebaceous gland hyperplasia of the vulva. Differences in age at presentation and clinical presentation compared with classic sebaceous gland hyperplasia from the head and neck region were noted. Also, it was rarely included in the clinical differential diagnosis. Immunohistochemical studies to determine any possible association with the Muir-Torre syndrome were performed and mismatch repair protein loss was not identified. PMID:24901406

  14. Localized amyloidosis of the vulva with and without vulvar intraepithelial neoplasia: report of a series.

    PubMed

    Quddus, M Ruhul; Sung, C James; Simon, Rochelle A; Lawrence, W Dwayne

    2014-10-01

    Localized primary cutaneous amyloidosis is uncommon in Europe and North America and is infrequently reported in the English literature. The constituents of such deposits have not been previously examined; this series characterizes amyloid deposits in localized vulvar amyloidosis and their association with vulvar intraepithelial neoplasia. All biopsies and excisions of vulva over 18 months were reviewed. Cases with suspected amyloidosis were retrieved after institutional review board approval. Twenty cases mimicking amyloidosis were selected as controls. All study and control cases were stained with Congo red. Four Congo red-positive study cases were studied by liquid chromatography-tandem mass spectrometry. Of 27 Congo red-positive study cases, 25 were then examined by immunohistochemical stains with antibodies to cytokeratin 5 (CK5) and cytokeratin 14 (CK14). Of 149 cases reviewed, 26 localized and 1 systemic vulvar amyloidosis were identified. Liquid chromatography-tandem mass spectrometry analysis of the deposits revealed unique peptide profile consistent with CK5 and CK14. Immunohistochemical staining with antibodies to CK5 and CK14 also detected these components in the deposits. The vulvar deposit of systemic amyloidosis consisted of amyloid light chain (?)-type amyloid deposit. All control cases were negative for Congo red. Keratin-associated amyloid materials (CK5 and CK14) were found to be unique in localized vulvar amyloidosis. Leakage of keratins from the basal layer of the epithelium into the superficial dermis may have been the possible source of the deposits. It appears to be associated with both high-grade and low-grade vulvar intraepithelial neoplasias and, rarely, lichen sclerosus, seborrheic keratosis, and benign vulvar skin. PMID:25149547

  15. Genomic aberration patterns and expression profiles of squamous cell carcinomas of the vulva.

    PubMed

    Micci, Francesca; Panagopoulos, Ioannis; Haugom, Lisbeth; Dahlback, Hanne-Sofie S; Pretorius, Maria E; Davidson, Ben; Abeler, Vera M; Tropé, Claes G; Danielsen, Håvard E; Heim, Sverre

    2013-06-01

    Little is known about the genomic abnormalities of squamous cell carcinomas (SCC) of the vulva and how they correlate with gene expression. We determined the genomic and expression profiles of 15 such SCC using karyotyping, DNA ploidy analysis, arrayCGH, and expression arrays. Four of the five cases with clonal chromosomal aberrations found by G-banding showed highly abnormal karyotypes with multiple rearrangements. The imbalances scored by arrayCGH mapped to different chromosomes with losses being more common than gains. Frequent losses were scored from 3p and 8p whereas gains were frequent from 3q and 8q (loss of 8p with concomitant gain of 8q mostly occurred via 8q isochromosome formation). This is the first study of vulvar tumors using arrayCGH, and some frequent imbalances could be defined precisely. Of particular note were the sometimes large, sometimes small deletions of 3p and 9p which had minute areas in 3p14 and 9p23 as minimal commonly deleted regions. FHIT (3p14) and PTPRD (9p23) are the only genes here. They were both lost in seven cases, including homozygous losses of PTPRD in four tumors. Using qPCR we could demonstrate deregulation of the FHIT gene in tumor cells. Hence, this gene is likely to play a pathogenetic role in vulvar SCC tumorigenesis. Expression array analyses also identified a number of other genes whose expression profile was altered. Notable among the downregulated genes were MAL (in 2q11), KRT4 (in 12q13), and OLFM4 (in 13q14), whereas upregulated genes included SPRR2G (in 1q21.3) and S100A7A (in 1q21.3). PMID:23404381

  16. Clinical Manifestations and Therapeutic Management of Vulvar Cellulitis and Abscess: Methicillin-resistant Staphylococcus aureus, Necrotizing Fasciitis, Bartholin Abscess, Crohn Disease of the Vulva, Hidradenitis Suppurativa.

    PubMed

    Wood, Sara C

    2015-09-01

    Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to life-threatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Ineffective antibiotics or deferring necessary surgical debridement have proven to be costly to the patient, and the gynecologist must maintain an appropriately high index of suspicion. Employing a multidisciplinary team approach to care for vulvar cellulitis can guide treatment from antibiotic therapies to more aggressive surgical debridement. PMID:26125959

  17. Paraneoplastic stiff person syndrome associated with colon cancer misdiagnosed as idiopathic Parkinson’s disease worsened after capecitabine therapy

    PubMed Central

    2013-01-01

    Objectives To refresh clinical diagnostic dilemmas in patients presenting with symptoms resembling to those of parkinsonism, to report rare association of colon cancer and paraneoplastic stiff person syndrome (SPS), and to draw attention on the possible correlation of capecitabine therapy with worsening of paraneoplastic SPS. Methods Case report of the patient with paraneoplastic SPS due to colon cancer that was misdiagnosed as idiopathic Parkinson’s disease (iPD), whose symptoms worsened after beginning adjuvant capecitabine chemotherapy. Results We describe a 55-year-old woman with subacute onset of symmetrical stiffness and rigidity of the truncal and proximal lower limb muscles that caused lower body bradykinesia, gait difficulties, and postural instability. Diagnose of iPD was made and levodopa treatment was initiated but failed to provide beneficial effect. Six months later, colon cancer was discovered and the patient underwent surgical procedure and chemotherapy with capecitabine thereafter. Aggravation of stiffness, rigidity, and low back pain was observed after the first chemotherapy cycle and capecitabine was discontinued. Furthermore, levodopa was slowly discontinued and low dose of diazepam was administered which resulted in partial resolution of the patient’s symptoms. Conclusion Paraneoplastic SPS is rare disorder with clinical features resembling those of parkinsonian syndrome and making the correct diagnosis remains a challenge. The diagnosis of parkinsonian syndrome should be re-examined if subsequent examinations discover an associated malignant process. Although it remains unclear whether the patients with history of SPS are at the greater risk for symptoms deterioration after administration of capecitabine, clinicians should be aware of capecitabine side effects because recognition and appropriate management can prevent serious adverse outcomes. PMID:24028681

  18. Lipoblastoma-like tumor of the vulva: further characterization in 8 new cases.

    PubMed

    Mirkovic, Jelena; Fletcher, Christopher D M

    2015-09-01

    Lipoblastoma-like tumor of the vulva (LLTV) is an exceptionally rare adipocytic mesenchymal tumor with only 4 cases reported previously. The aim of this study is to help characterize this tumor type. Eight cases of LLTV were identified in the consult files of one of the authors (C.D.M.F.). Clinical data and follow-up information were obtained from the referring pathologists. Detailed clinical information is available in all 8 cases. Patient age ranged from 17 to 46 years (median 27 y). Lesions presented as a vulvar mass with a variable growth rate, sometimes being painful. The most common preoperative clinical diagnosis was a Bartholin gland abnormality (4). The size of the mass ranged from 3.5 to 15 cm (median 5.6 cm). The lesions were described as grossly myxoid, mucoid, or gelatinous (4), well defined (4), and lobulated (3). None of the lesions exhibited necrosis. Histologically, LLTVs were lobulated and composed of variable proportions of mature adipocytes, bland univacuolated and bivacuolated lipoblasts, and spindle cells with short stubby nuclei in a diffusely myxoid background with prominent branching vessels. Nuclear atypia was minimal. No necrosis and only rare mitotic activity was identified. Only 1 of 7 tumors (in a 26-y-old patient) was positive for PLAG1 and retinoblastoma (Rb). Rb was lost, and PLAG1 was not expressed in all other tumors. HMGA2 was negative in 6 of 6 cases tested. Tumors were negative for S100 (5/5), MDM2, and CDK4 (5/6; 1 with just scattered cells positive for both antibodies). Two of 5 cases were positive for CD34. Fluorescence in situ hybridization for DDIT3 gene rearrangement was negative in 5 cases tested. The follow-up interval ranged from 4 months to 11 years (median 2.75 y). Three patients developed 1 local recurrence, 7 months, 2 years, and 8 years, respectively, after excision of the primary tumor. None of the patients has developed metastatic disease. LLTVs are indolent adipocytic mesenchymal tumors arising in adults. Lack of PLAG1 and HMGA2 expression in the majority of LLTV suggests that these lesions are distinct from "true" lipoblastoma. The loss of Rb in the majority of cases suggests a possible role of 13q chromosomal alterations and a possible relationship with the spindle cell lipoma tumor family. PMID:25929353

  19. Complementary use of optical coherence tomography and 5-aminolevulinic acid induced fluorescent spectroscopy for diagnosis of neoplastic processes in cervix and vulva

    NASA Astrophysics Data System (ADS)

    Sapozhnikova, Veronika V.; Shakhova, Natalia M.; Kamensky, Vladislav A.; Kuranov, Roman V.; Loshenov, Victor B.; Petrova, Svetlana A.

    2003-07-01

    A new approach to improving the diagnostic value of optical methods is suggested, which is based on a complementary investigation of different optical parameters of biotissues. The aim of this paper is comparative study of the feasibility of two optical methods - fluorescence spectroscopy and optical coherence tomography - for visualization of borders of neoplastic processes in the uterine cervix and vulva. Fluorescence spectroscopy is based on the detection of biochemical and optical coherence tomography on backscattering properties in norm and pathological changes of tissues. By means of these optical methods changes in biochemical and morphological properties of tissues were investigated. A parallel analysis of these two optical methods and histology from the center of tumors and their optical borders was made. Thirteen female patients with neoplastic changes in uterine cervix and vulva were enrolled in this study. The borders of the tumor determined by optical methods (fluorescence spectroscopy and optical coherence tomography) are coinciding with the biopsy proved ones. In addition, OCT and fluorescence borders of tumor in the uterine cervix and vulva exceeds colposcopically detectable borders, the averaging difference 2 mm. In future optical methods would considerably enhance diagnostic accuracy of conventional methods used in oncogynecology.

  20. Extranodal natural killer/T-cell lymphoma, nasal type, involving the skin, misdiagnosed as nasosinusitis and a fungal infection: A case report and literature review

    PubMed Central

    ZHENG, YAN; JIA, JINJING; LI, WENSHENG; WANG, JUAN; TIAN, QIONG; LI, ZHENGXIAO; YANG, JING; DONG, XINYU; PAN, PING; XIAO, SHENGXIANG

    2014-01-01

    The present study reports a case of extranodal natural killer (NK)/T-cell lymphoma, nasal type, involving the skin. The clinical manifestations, pathological characteristics, treatment and prognosis of the case were analyzed to improve the clinical diagnosis and treatment for this disease. The patient was a 56-year-old male, presenting with dark red nodules and plaques that had been visible on the nose for half a year. Based on the skin lesions and histopathological and immunohistochemical examination results, the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. This disease has unique histopathological and immunohistochemical features and a high malignancy. The condition tends to be misdiagnosed and has a poor prognosis, but seldom involves the skin. In the present case, only radiotherapy was performed, with no relapse occurring within 6 months. PMID:25289105

  1. Extraskeletal myxoid chondrosarcoma of the vulva with PLAG1 gene activation: molecular genetic characterization of 2 cases.

    PubMed

    Dotlic, Snjezana; Gatalica, Zoran; Wen, Wenhsiang; Ghazalpour, Anatole; Mangham, Chas; Babic, Damir; Zekan, Josko; Vranic, Semir

    2014-08-01

    Extraskeletal myxoid chondrosarcoma (EMC) is a rare mesenchymal neoplasm, rarely reported in the genitourinary tract with only 5 cases reported in the vulva. We investigated 2 cases of vulvar sarcomas whose morphologic appearance and immunohistochemical profiles were consistent with EMC using fluorescence in situ hybridization (FISH), reverse-transcription polymerase chain reaction, and a whole genome expression array. FISH and reverse-transcription polymerase chain reaction assays showed no EWSR1 and NR4A3 loci rearrangements. Microarray-based analysis also revealed no changes in NR4A3 and EWSR1 gene transcription levels. Microarray data showed a significant downregulation of the muscle-related genes (eg, myosin heavy chain family, actins, myoglobin, desmin, creatine kinase, troponins) and cytokeratins (KRT6A, 6B, 13, 14, and 78), upregulation of several neuron-specific genes [neural cell adhesion molecule 1 (NCAM-1/CD56), neurofilament (NEFH)], along with some well-characterized tumor biomarkers [carbonic anhydrase IX (CA-9), topoisomerase II? (TOP2A), matrix metalloproteinases (MMP-7, MMP-9), CDKN2 gene (p16-INK4a), checkpoint homolog 2 (CHEK2)]. Notably, both tumors showed upregulation of the pleomorphic adenoma gene 1 (PLAG1), and in 1 case PLAG1 gene rearrangement was detected by break-apart FISH. Some vulvar tumors with morphologic and immunohistochemical characteristics of EMC may represent a molecular genetic entity separate from EMCs arising in other locations. PLAG1 gene activation appears to be involved in the development of these neoplasms. PMID:24185117

  2. Primary Ewing sarcoma of vulva, confirmed with molecular cytogenetic analysis: A rare case report with diagnostic and treatment implications.

    PubMed

    Rekhi, Bharat; Chinnaswamy, Girish; Vora, Tushar; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Primary vulvar Ewing sarcoma (ES)/PNET is an uncommonly documented tumor, especially with molecular results. A 10-year-old girl presented with left vulvar swelling, a year ago. Her abdominopelvic ultrasound revealed a 12 cm × 8 cm sized, mixed echogenic blood-filled lesion in the left vulva; radiologically considered as a hematoma. Vulvectomy revealed a multinodular grey-brown tumor, microscopically comprising malignant round cells. Immunohistochemically, tumor cells diffusely expressed MIC2/CD99 and Fli1 and subsequently displayed EWSR1 rearrangement, confirming diagnosis of ES/PNET. Subsequently, PET-CT scan revealed residual local lesion with lung metastases. The patient was induced on EFT 2001 chemotherapy protocol. Three months after chemotherapy completion, there was no metabolically active disease on PET scan. Four months later, MRI disclosed recurrent primary and metastatic pulmonary lesions. She was planned for scar excision and adjuvant radiotherapy, but unfortunately defaulted further treatment. This forms the eighth case of primary vulvar ES/PNET confirmed with molecular cytogenetic result, underscoring therapeutic value of objective diagnosis in such cases. PMID:26275259

  3. Different DNA damage and cell cycle checkpoint control in low- and high-risk human papillomavirus infections of the vulva.

    PubMed

    Santegoets, Lindy A M; van Baars, Romy; Terlou, Annelinde; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; van der Meijden, Willem I; Helmerhorst, Theo J M; Blok, Leen J

    2012-06-15

    Human papillomavirus (HPV) infections may result in benign hyperplasia, caused by low-risk HPV types, or (pre)malignant lesions caused by high-risk HPV types. The molecular basis of this difference in malignant potential is not completely understood. Here, we performed gene profiling of different HPV infected vulvar tissues (condylomata acuminata (n = 5), usual type vulvar intraepithelial neoplasia (uVIN) (n = 9)) and control samples (n = 14) using Affymetrix Human U133A plus 2 GeneChips. Data were analyzed using OmniViz®, Partek® and Ingenuity® Software. Results were validated by real-time RT-PCR and immunostaining. Although similarities were observed between gene expression profiles of low- and high-risk HPV infected tissues (e.g., absence of estrogen receptor in condylomata and uVIN), high-risk HPV infected tissues showed more proliferation and displayed more DNA damage than tissues infected with low-risk HPV. These observations were confirmed by differential regulation of cell cycle checkpoints and by increased expression of DNA damage-biomarkers p53 and ?H2AX. Furthermore, FANCA, FANCD2, BRCA1 and RAD51, key players in the DNA damage response, were significantly upregulated (p < 0.05). In addition, we compared our results with publicly available gene expression profiles of various other HPV-induced cancers (vulva, cervix and head-and-neck). This showed p16(INK4a) was the most significant marker to detect a high-risk HPV infection, but no other markers could be found. In conclusion, this study provides insight into the molecular basis of low- and high-risk HPV infections and indicates two main pathways (cell cycle and DNA damage response) that are much stronger affected by high-risk HPV as compared to low-risk HPV. PMID:21815142

  4. Disorders of the Vulva

    MedlinePLUS

    ... microscope in a laboratory. Chemotherapy: The treatment of cancer using certain drugs to destroy malignant cells. Cyst: A sac or pouch filled with fluid. Estrogen: A female hormone produced in the ovaries. Genital Herpes: A sexually ...

  5. Cancer of the Vulva

    MedlinePLUS

    ... at a Glance Show More At a Glance Estimated New Cases in 2015 5,150 % of All New Cancer Cases 0.3% Estimated Deaths in 2015 1,080 % of All Cancer ... vulvar cancer is rare. Common Types of Cancer Estimated New Cases 2015 Estimated Deaths 2015 1. Breast ...

  6. CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

    NASA Astrophysics Data System (ADS)

    Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

    1995-05-01

    The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

  7. Associations between HLA-A\\B\\DRB1 polymorphisms and risks of vulvar lichen sclerosus or squamous cell hyperplasia of the vulva.

    PubMed

    Liu, G L; Cao, F L; Zhao, M Y; Shi, J; Liu, S H

    2015-01-01

    In this study, we aimed to explore the associations between HLA-A\\B\\DRB1 polymorphisms and the risks of vulvar lichen sclerosus (VLS) or squamous cell hyperplasia of the vulva (SCHV) in Han Chinese women. We enrolled 76 Han Chinese women with VLS (Group A), 74 with SCHV (Group B), and 66 healthy women (control group) in this study. Polymerase chain reaction amplification with sequence specific primers (PCR-SSP) was used to determine HLA-A\\B\\DRB1 polymorphisms. Compared with the control group, HLA-A*11, -B*15, and -DRB1*12 were present at a higher frequency in groups A and B, while HLA-B*13 was present at a higher frequency in group A. Fewer women in group A carried HLA-A*31, -DRB1*01, and -DRB1*03 genotypes and fewer women in group B carried HLA-B*40 and -DRB1*03 genotypes. Significant differences were found between group B and the control group for HLA-A*11, -B*15, -B*40, and -DRB1*03, and between group A and the control group for HLA-B*15 and -DRB1*12. The HLA-A*11, HLA-B*13, HLA-B*15, and HLA-DRB1*12 genotypes were associated with a higher risk of VLS, while the HLA-A*31, HLA-DRB1*01, and HLA-DRB1*03 genotypes were associated with a lower risk of VLS. In addition, carrying HLA-A*11, HLA-B*15, HLA-B*35, and HLA-DRB1*12 genotypes, and carrying HLA-B*40 and HLA-DRB1*03 genotypes were found to be risk or protective factors for SCHV, respectively. PMID:26662388

  8. Differential diagnosis of a carcinoma of the maxillary sinus that resembles a sparganum infection: A case report

    PubMed Central

    YU, MEI-HONG; CHEN, CHUN-LEI; LIU, XIAO-LI; XU, XIAO-WEI

    2015-01-01

    Primary malignant tumors of the maxillary sinuses are rare. The present study reports the case of a maxillary sinus adenocarcinoma that was misdiagnosed as a frog sparganum infection, and discusses the differential diagnosis between the two diseases. The patient was ultimately diagnosed with a carcinoma of the left maxillary sinus that presented as a progressive mass in the left eye and the maxillary sinus. Eosinophilic infiltration was observed in the subcutaneous tissue, and the patient had experienced previous exposure to undercooked frog. Although an anti-sparganum ELISA was performed and the results were negative, a sparganosis infection was initially diagnosed. However, following the application of anti-sparganosis treatment, no improvements were observed. Histological examination of an orbital mass resection revealed an adenocarcinoma with bone metastases. To the best of our knowledge, the present study is the first to report a maxillary sinus carcinoma misdiagnosed as sparganosis. Therefore, the findings of the current study should be considered in the differential diagnosis between a carcinoma of the maxillary sinus and sparganosis. Avoidance of misdiagnosis at an early stage is crucial for effective diagnosis and treatment of sinonasal malignancies. PMID:26622486

  9. Status cataplecticus misdiagnosed as recurrent syncope.

    PubMed

    Calabrò, R S; Savica, R; Laganà, A; Magaudda, A; Imbesi, D; Gallitto, G; La Spina, P; Musolino, R

    2007-12-01

    A 76-year-old patient, since the age of 45, presented with frequent attacks often triggered by emotional stimuli and characterised by forward head drop and a fall to the ground without loss of consciousness. Clinically these episodes were misinterpreted as pseudoseizures and treated with clomipramine for more than 20 years. In spite of this chronic therapy, during the last year, the attacks presented with a daily recurrence and, moreover, after arbitrary clomipramine withdrawal, they increased in frequency until they became subcontinuous. Videopolygraphic analysis, multiple sleep latency test (MSLT) and human leukocyte antigen (HLA) association studies were suggestive of narcolepsy and the recurrent episodes, diagnosed as status cataplecticus, recovered after citalopram administration. PMID:18175082

  10. Cardiac asystoles misdiagnosed as epileptic seizures.

    PubMed

    Chiesa, Valentina; Vignoli, Aglaia; Canevini, Maria Paola

    2015-01-01

    We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17?s after the beginning of asystole. Synus rhythm reappeared 32?s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred. PMID:25628317

  11. Leiomyoma in Vulva: A Diagnostic Dilemma

    PubMed Central

    Shetty, Jyothi; Srilatha, P. S.

    2014-01-01

    With the help of this case we summarize some crucial features to be picked up from history and examination before labeling a case as Bartholin's abscess or cyst. A 20-year old unmarried girl, deaf and mute since birth, was initially diagnosed to have Bartholin's abscess. On careful reexamination after inflammation subsided, a decision of excision of this tumor was taken. Intraoperatively it was found to be well encapsulated. Histopathology ascertained the diagnosis of vulval leiomyoma. PMID:24660079

  12. Angiosarcoma of the Vulva: A Case Report.

    PubMed

    Sheinis, Michal; Cesari, Matthew; Selk, Amanda

    2016-01-01

    This case illustrates that a very benign looking lesion can be an aggressive cancer. Vulvar lesions need a biopsy to rule out malignancy if they are painful, progressing in size, or changing in appearance. PMID:26704338

  13. Acanthocephalan infection and sparganosis in a green tree snake (Dendrelaphis punctulata).

    PubMed

    Hill, A G; Ladds, P W; Spratt, D M

    2014-09-01

    Acanthocephalan and spargana parasites were identified within a body wall mass during exploratory surgery in a wild green tree snake. Acanthocephalan parasites have not previously been reported in this species. Surgical excision, the treatment of choice, could not be achieved because of the extensive infiltration of the coelomic cavity. PMID:25156057

  14. Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.

    PubMed Central

    Eberhard, Mark L.; Thiele, Elizabeth A.; Yembo, Gole E.; Yibi, Makoy S.; Cama, Vitaliano A.; Ruiz-Tiben, Ernesto

    2015-01-01

    Thirty-seven unusual specimens, three from Ethiopia and 34 from South Sudan, were submitted since 2012 for further identification by the Ethiopian Dracunculiasis Eradication Program (EDEP) and the South Sudan Guinea Worm Eradication Program (SSGWEP), respectively. Although the majority of specimens emerged from sores or breaks in the skin, there was concern that they did not represent bona fide cases of Dracunculus medinensis and that they needed detailed examination and identification as provided by the World Health Organization Collaborating Center (WHO CC) at Centers for Disease Control and Prevention (CDC). All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp. Age of cases ranged between 7 and 70 years (mean 25 years); 21 (57%) patients were male and 16 were female. The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite. PMID:26055739

  15. Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.

    PubMed

    Eberhard, Mark L; Thiele, Elizabeth A; Yembo, Gole E; Yibi, Makoy S; Cama, Vitaliano A; Ruiz-Tiben, Ernesto

    2015-08-01

    Thirty-seven unusual specimens, three from Ethiopia and 34 from South Sudan, were submitted since 2012 for further identification by the Ethiopian Dracunculiasis Eradication Program (EDEP) and the South Sudan Guinea Worm Eradication Program (SSGWEP), respectively. Although the majority of specimens emerged from sores or breaks in the skin, there was concern that they did not represent bona fide cases of Dracunculus medinensis and that they needed detailed examination and identification as provided by the World Health Organization Collaborating Center (WHO CC) at Centers for Disease Control and Prevention (CDC). All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp. Age of cases ranged between 7 and 70 years (mean 25 years); 21 (57%) patients were male and 16 were female. The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite. PMID:26055739

  16. Neurological adverse effects of methylphenidate may be misdiagnosed as meningoencephalitis.

    PubMed

    Snell, Luke Blagdon; Bakshi, Dinkar

    2015-01-01

    We present a case of adverse neurological effects of methylphenidate therapy for attention deficit and hyperactivity disorder (ADHD). A 7-year-old boy presented to the emergency department (ED) having developed ataxic gait, orofacial dyskinesias and choreoathetosis of the limbs. The results of all blood investigations, EEG and CT scan of the head were unremarkable. Subsequently, a detailed history revealed he was being treated for ADHD, being started on methylphenidate in the past 3 months. Discontinuation of methylphenidate led to significant and rapid amelioration of neurological adverse effects. PMID:26082097

  17. Bilateral acute iris transillumination (BAIT) initially misdiagnosed as acute iridocyclitis.

    PubMed

    Gonul, Saban; Bozkurt, Banu

    2015-01-01

    Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber, and sphincter paralysis. We report the case of a 30-year-old male who was initially diagnosed with acute iridocyclitis in a different clinic and treated with topical and systemic corticosteroids. He was referred to our clinic to seek another opinion because his symptoms did not improve. An ocular examination revealed bilateral pigment dispersion into the anterior chamber, diffuse iris transillumination, pigment dusting on the anterior lens capsule, atonic and distorted pupils, and increased intraocular pressure, suggesting a diagnosis of BAIT rather than iridocyclitis. Clinicians should be aware of the differential diagnosis of syndromes associated with pigment dispersion from iridocyclitis to avoid aggressive anti-inflammatory therapy and detailed investigation for uveitis. PMID:25945534

  18. Misdiagnosing the Teacher Quality Problem. CPRE Policy Briefs. RB-49

    ERIC Educational Resources Information Center

    Ingersoll, Richard M.

    2007-01-01

    This issue of CPRE Policy Briefs summarizes the findings on issues related to teacher quality in the chapter by the author in the book, "The State of Education Policy Research" (Cohen, Fuhrman, Mosher, Eds., 2007). This report also draws on discussions that took place during a summer, 2006, policy briefing on teacher labor-market issues held in…

  19. Dermatofibrosarcoma Protuberans of the Vulva With Myoid Differentiation.

    PubMed

    Bernárdez, Claudia; Machan, Salma; Molina-Ruiz, Ana María; Pérez de la Fuente, Teresa; Pavón, María; Carrillo, Irene; Fortes, José; Requena, Luis

    2015-09-01

    Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft-tissue tumor characterized by a relatively high risk for local recurrence and low risk for metastasis. Many histopathologic variants of DFSP have been described, including the fibrosarcomatous and myoid variants, which may obscure the diagnosis in some cases, especially when arising in unusual locations. Of all the variants described so far, the only one with prognostic relevance is the FS-DFSP variant, which implies tumor progression and a higher possibility for metastasis. The authors report a case of a giant DFSP, located on the vulvar area, which histopathologically showed areas of fibrosarcomatous and myoid differentiation, and discuss the importance of the myoid variant in regards of the debated histogenesis of DFSP. PMID:25943241

  20. Irradiation combined with surgery for function preservation in the treatment of extramedullary plasmacytoma of the left labia majora during pregnancy: A case report

    PubMed Central

    HE, JINLAN; ZHANG, YULONG; SHEN, QIN; LI, YAN; LIU, ZHE; PENG, XINGCHEN; SHEN, YALI; YIN, RUI; CHEN, NIANYONG

    2015-01-01

    Extramedullary plasmacytoma (EMP) in the vulva is extremely rare. The current study presents, for the first time, a case of EMP in the left labia majora in a 36-year-old patient during pregnancy. A painful 7×4×2-cm mass with ulceration, pus and blood scabs, previously misdiagnosed as vulvar ulcer in a local hosipital, was proven to be an EMP by biopsy. Upon magnetic resonance imaging, the tumor was shown to occur in the left labia majora without lymphadenopathy. A complete multiple myeloma (MM) workup excluded coexistence with MM. The goal of treatment was to eradicate the tumor while synchronously preserving the vulva. Therefore, following the termination of the pregnancy, radiotherapy with a total dose of 4,500 cGy markedly reduced the size of the tumor. An extended local excision of the residual tumor, and anaplasty of the vulva preserved the appearance and function of the vulva to the utmost. No post-operative radiation was administered, as the resection margins were not microscopically involved. There was no relapse, metastasis or progression to MM in a 9-month post-operative follow-up period, but close follow-up and long-term surveillance are required. PMID:26722319

  1. Bilateral dissecting aneurysms of the internal carotid arteries misdiagnosed as skull base tumors: A case report

    PubMed Central

    QI, BIN; LU, ZHI-CHENG; WU, WEI; LI, YI-PING

    2015-01-01

    A 45-year-old female presented with a five-year history of intermittent headaches and a two-month history of left hypoglossal nerve palsy. Computed tomography and magnetic resonance imaging of the head revealed space-occupying lesions in the base of the skull with accompanying bone erosion, which were suggestive of skull base chordomas. However, an endoscopic endonasal transsphenoidal biopsy was also performed and pathological analysis of the lesion suggested a thrombosis. Cranial magnetic resonance angiography revealed old dissecting aneurysms of the bilateral internal carotid arteries (ICAs), which led to a definitive diagnosis. The patient was successfully treated with anticoagulants and antiplatelet agents. The present case study suggests that, for patients with space-occupying lesions of the skull base and symptoms of cranial nerve palsy, the possibility of an ICA dissection should be prioritized during the differential diagnosis. PMID:26622598

  2. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease

    PubMed Central

    Lee, Kyung Jin; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-01-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved.

  3. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease.

    PubMed

    Lee, Kyung Jin; Kim, Jaeyeon; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-12-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved. PMID:26730366

  4. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child

    PubMed Central

    Geramizadeh, Bita; Khademi, Bijan; Karimi, Mehran; Shekarkhar, Golsa

    2015-01-01

    Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin. PMID:26604519

  5. Pulmonary arterial hypertension associated with rare cause of ANCA-associated vasculitis misdiagnosed as idiopathic one

    PubMed Central

    Li, Yi; Yi, Qun

    2015-01-01

    Pulmonary arterial hypertension (PAH) and ANCA-associated vasculitis (AAV) are both rare and complex diseases with poor prognosis especially when misdiagnosis. We report a rare case of a young woman presented with idiopathic pulmonary arterial hypertension (IPAH), but who was later found to have PAH associated with AAV. This case reminds us the very importance of differential diagnosis to PAH patients and the identification of rare cause likes ANCA-associated vasculitis. To our knowledge, this patient represents the first published case of misdiagnosis of PAH secondary to ANCA-associated vasculitis. PMID:26629233

  6. Juvenile Kearns-Sayre syndrome initially misdiagnosed as a psychosomatic disorder.

    PubMed Central

    Nørby, S; Lestienne, P; Nelson, I; Nielsen, I M; Schmalbruch, H; Sjö, O; Warburg, M

    1994-01-01

    We have investigated a 15 year old girl with progressive external ophthalmoplegia, including bilateral ptosis and retinal rod and cone cell dysfunction with atypical retinal pigmentation, complicated by cerebellar ataxia, partial cardiac conduction block, and diabetes mellitus. In infancy she had a severe crisis of bone marrow depression, and as a child she suffered from hypersensitivity to light, increasing fatigue, and vertigo, signs that were initially though to be psychosomatic. Histological examination showed mitochondrial myopathy, and subsequent mitochondrial DNA (mtDNA) analysis showed a deletion of approximately 5500 base pairs in 35 to 40% of her muscle mtDNA. We therefore conclude that this patient has developed the Kearns-Sayre syndrome after a Pearson syndrome-like crisis in her first year of life. Images PMID:8151637

  7. Mucinous cystadenoma of the appendix misdiagnosed as cystic hydatid disease of the liver: a case report

    PubMed Central

    Krieg, Andreas; Esch, Jan Schulte am; Poll, Ludger W; Braunstein, Stefan; Knoefel, Wolfram T

    2008-01-01

    Introduction Primary neoplastic lesions presenting with a mucocele of the appendix are very rare and can be divided into benign variants of mucinous adenomas or cystadenomas, mucinous tumours of uncertain malignant potential or mucinous cystadenocarcinomas. Most of these tumourous mucoceles are asymptomatic and are found incidentally. The major complication of neoplastic mucinous appendiceal tumours is the development of a pseudomyxoma peritonei due to spreading of mucin-producing cells within the abdominal cavity. Case presentation A 44-year-old man presented with a history of non-specific symptoms of right upper abdominal pain. Abdominal ultrasound and computed tomography scan identified a cystic mass consistent with the morphological characteristics of an echinococcal hydatid cyst. After completing systemic albendazole therapy, an explorative laparotomy revealed a cystic tumour of the appendix. Ileocaecal resection was performed and pathology reports confirmed the diagnosis of a mucinous cystadenoma of the appendix. The postoperative course was uneventful. Conclusion Here we present the case of a man with a mucinous cystadenoma of the appendix mimicking cystic hydatid disease. We discuss the importance of re-evaluation and differential diagnostic reflections in cases of appendiceal mucocele. PMID:18578871

  8. A Case of Misdiagnosed Cesarean Scar Pregnancy with a Viable Birth at 28 Weeks

    PubMed Central

    Nukaga, Sakiko; Aoki, Shigeru; Kurasawa, Kentaro; Takahashi, Tsuneo; Hirahara, Fumiki

    2014-01-01

    We report our experience with a case of presumptive cesarean scar pregnancy, based on detection of a gestational sac (GS) in early pregnancy at the site of a previous cesarean scar. The GS grew into the uterine cavity as the pregnancy progressed, showing an ultrasound image similar to that of a normal pregnancy. Thus, the pregnancy continued, resulting in a viable birth at 28 weeks of gestation. Cesarean scar pregnancy is classified as myometrial implantation or implantation growth into the uterine cavity. In the latter type, the gestational sac moves upward with increasing gestational weeks and it shows the same ultrasound image as a normal pregnancy. Therefore, the diagnosis must be made in the early pregnancy. PMID:25371837

  9. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis

    SciTech Connect

    Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. )

    1991-07-01

    We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

  10. Rare case of external dental fistula of the submental region misdiagnosed as inverted follicular keratosis and thyroglossal duct cyst

    PubMed Central

    Sato, Toshihisa; Suenaga, Hideyuki; Igarashi, Masaki; Hoshi, Kazuto; Takato, Tsuyoshi

    2015-01-01

    Introduction Odontogenic cutaneous sinus tract is a relatively rare occurrence that can be complicated to diagnose. The presence of a cutaneous lesion is often not even partly associated with a dental etiology because of the less frequency of occurrence in the case of dental symptoms. Consequently, the underlying dental cause is often missed leading to inappropriate diagnosis and treatment. Case presentation Here, we report the case of a 45-year-old man who presented with a persistent lesion of the cervical region. At the time of presentation, the lesion had been present for approximately one year with a gradual increase in size but no specific symptoms. The patient had previously undergone punch resection under local anesthesia, which resulted in a histopathological diagnosis of inverted follicular keratosis. A diagnosis was made of an odontogenic cutaneous sinus tract secondary to chronic apical periodontitis of the left mandibular second molar. Discussion Cutaneous sinus tract in the face and neck is most likely to develop intraorally. Root canal treatment or surgical extractions are the common treatment choices. A previously reported review of 137 cases found that 106 (77%) were treated by extraction and 27 (20%) were treated by surgical or conservative nonsurgical endodontic therapy. Conclusion Early diagnosis of cutaneous sinus tract using proper aid is responsible for shortening the treatment duration and avoiding unnecessary treatment. PMID:26413920

  11. Tularaemia after tick exposure - typical presentation of rare disease misdiagnosed as atypical presentation of common diseases: a case report.

    PubMed

    Switaj, Karolina; Olszynska-Krowicka, Maria; Zarnowska-Prymek, Hanna; Zaborowski, Piotr

    2009-01-01

    A 44-year-old female was admitted because of tender, enlarged inguinal lymph nodes with a history of tick bite five weeks earlier. In the place of a tick bite on the skin a small ulcer was present. The primary symptoms before admission suggested typical diseases related to tick bite such as Lyme borreliosis and tick-borne encephalitis, what corresponded with positive IgM ELISA test for Lyme borreliosis. The course of disease however clarified the diagnosis of tularaemia, which is a relatively rare disease in Poland (6 cases per 40 million population are reported annually). The ultimate diagnosis was confirmed by serological tests. PMID:19830027

  12. Unbalanced interchromosomal insertion diagnosed prenatally by FISH, with carrier mother, previously misdiagnosed as having a balanced reciprocal translocation

    SciTech Connect

    Yu, M.T.; Leiber, E.; Qazi, Q.

    1994-09-01

    Insertion translocations are rare. A carrier with a balanced insertion translocation is most likely to be detected through offspring with an unbalanced translocation. We with to report a case where a correct diagnosis, made prenatally with FISH, corrected the initial misdiagnosis of the mother in another institute. PDL received an amniotic fluid sample from a 28 y.o. woman (G5P2Sab1TOP1) at 19 wks gestation. The indications were a reported balanced translocation, t(6;13), in the mother and a previous daughter with an unbalanced translocation. Chromosome analysis of the amniocytes showed a female karyotype with an abnormal chr. 13. Since the mother was diagnosed as having t(6;13)(q21;q34), the der(13) in the amniocytes was initially assumed to result from an adjacent segregation of the t(6;13). However, the banding patterns of this abnormal chr. 13 did not fit into the above defined translocation. With FISH and a chr. 13 painting probe, this der(13) was painted in the proximal and the distal thirds, but NOT in the middle region. This indicates that the middle section of the der(13) must have originated from 6q. The banding pattern is compatible with a direct insertion of 6q15 to 6q23.3 into 13q21.2. Thus, the fetus has partial trisomy 6q. After counseling, the mother elected to terminate the pregnancy but later changed her mind. An 8 lb 12 oz baby girl was born at 36 wks. (mother diabetic). Chromosome analysis of the newborn blood confirmed the dx. The mother was studied, using multicolor painting probes for chromosomes 13 and 6, a balanced direct insertion of 6q15 to 6q23.3 into chr. 13q21.2 was clearly shown. The previous affected daughter with a 13q+ is now 4 y.o. (a restudy is planned). She has microcephaly, severe developmental delay and other dysmorphic features. This case illustrates the advantage of using FISH to arrive at a definitive diagnosis of an insertion translocation.

  13. Vitamin B12 Deficiency and Hemoglobin H Disease Early Misdiagnosed as Thrombotic Thrombocytopenic Purpura: A Series of Unfortunate Events

    PubMed Central

    Andreadis, Panagiotis; Theodoridou, Stamatia; Pasakiotou, Marily; Arapoglou, Stergios; Gigi, Eleni; Vetsiou, Evaggelia; Vlachaki, Efthymia

    2015-01-01

    We herein would like to report an interesting case of a patient who presented with anemia and thrombocytopenia combined with high serum Lactic Dehydrogenase where Thrombotic Thrombocytopenic Purpura was originally considered. As indicated a central venous catheter was inserted in his subclavian vein which led to mediastinal hematoma and finally intubation and Intensive Care Unit (ICU) hospitalization. After further examination patient was finally diagnosed with B12 deficiency in a setting of H hemoglobinopathy. There have been previous reports where pernicious anemia was originally diagnosed and treated as Thrombotic Thrombocytopenic Purpura but there has been none to our knowledge that was implicated with hemothorax and ICU hospitalization or correlated with thalassemia and we discuss the significance of accurate diagnosis in order to avoid adverse reactions and therapy implications. PMID:26609455

  14. Misdiagnosed Case of Bronchial Carcinoid Presenting with Refractory Dyspnoea and Wheeze: A Rare Case Report and Review of Literature

    PubMed Central

    Santra, Avradip; Dutta, Pravati; Pothal, Sudarsan; Manjhi, Rekha

    2013-01-01

    A 59-year-old male smoker presented with persistent wheezing and occasional coughing that had been ongoing for two years and had been unsuccessfully treated with an inhalational ?2 agonist, an anticholinergic and an inhalational steroid in the last year. On clinical examination, a left-sided wheeze was detected. The initial chest X-ray was normal. A computed tomography (CT) scan of thorax demonstrated a mass lesion in the left main bronchus. On subsequent bronchoscopy, an endobronchial polypoid mass was detected in the left main bronchus, completely occluding the bronchial lumen. A biopsy taken from the mass revealed features of bronchial carcinoid. Bronchial carcinoid can present uncommonly with wheezes, resulting in misdiagnosis as bronchial asthma or chronic obstructive pulmonary disease (COPD). If an asthma or COPD patient does not respond to conventional therapy, a CT scan and subsequent bronchoscopy is warranted. PMID:23966830

  15. Notes from the Field: Group A Streptococcal Pharyngitis Misdiagnoses at a Rural Urgent-Care Clinic - Wyoming, March 2015.

    PubMed

    Harrist, Alexia; Van Houten, Clayton; Shulman, Stanford T; Van Beneden, Chris; Murphy, Tracy

    2016-01-01

    Group A Streptococcus (GAS) is the most common bacterial cause of pharyngitis, implicated in 20%-30% of pediatric and 5%-15% of adult health care visits for sore throat (1). Along with the sudden onset of throat pain, GAS pharyngitis symptoms include fever, headache, and bilateral tender cervical lymphadenopathy (1,2). Accurate diagnosis and management of GAS pharyngitis is critical for limiting antibiotic overuse and preventing rheumatic fever (2), but distinguishing between GAS and viral pharyngitis clinically is challenging (1). Guidelines for diagnosis and management of GAS pharyngitis have been published by the Infectious Diseases Society of America (IDSA)* (1). IDSA recommends that patients with sore throat be tested for GAS to distinguish between GAS and viral pharyngitis; however, IDSA emphasizes the use of selective testing based on clinical symptoms and signs to avoid identifying GAS carriers rather than acute GAS infections (1). Therefore, testing for GAS usually is not recommended for the following: patients with sore throat and accompanying symptoms (e.g., cough, rhinorrhea) that strongly suggest a viral etiology; children aged <3 years, because acute rheumatic fever is extremely rare in this age group; and asymptomatic household contacts of patients with GAS pharyngitis (1). IDSA recommends penicillin or amoxicillin as the treatment of choice based on effectiveness and narrow spectrum of activity. To date, penicillin-resistant GAS has never been documented (1). PMID:26719990

  16. Chemoradiotherapy in a Case of Malignant Syringocystadenocarcinoma Papilliferum of Vulva with Locoregional Failure

    PubMed Central

    Rao, Pamidimukkala Bramhananda; Ghosh, Saptarshi; Mohapatra, Manisha; Philip, N. Pramod; Kumar, P. Ravindra; Manam, Surendra; Karra, Pradeep; Jasti, Vijay Krishna

    2015-01-01

    Introduction. Syringocystadenocarcinoma papilliferum (SCACP) is an extremely rare malignant adnexal tumor, which arises from syringocystadenoma papilliferum. To date, less than 30 cases of malignant SCACP have been reported, of which locoregional metastases were found in only four cases. Case Report. A 57-year-old female patient who presented to our Oncology Department with a recurrent malignant SCACP of the left labia along with right inguinal lymphadenopathy. Pathological examination confirmed the diagnosis of malignant SCACP with right inguinal lymph node metastases. Due to the fixity of the right inguinal nodes, neoadjuvant chemotherapy was administered with Cisplatin and 5-Fluorouracil for four cycles, following which the primary tumor and the contralateral inguinal nodes regressed completely. Then definitive chemoradiation was delivered with five cycles of weekly Cisplatin and external beam pelvic irradiation up to a dose of 59.4?Gy. Patient is disease-free 11 months after treatment. Discussion. We here report the fifth case of malignant SCACP with locoregional metastases. This is the first case of malignant SCACP which has been treated with neoadjuvant chemotherapy followed by concurrent chemoradiation. Although surgery has been used most commonly, chemoradiation may also have a role in the treatment of malignant SCACP, especially in cases of locoregional metastases.

  17. ["Proximal type" epithelioid sarcoma of the vulva: differential diagnosis with other extrarenal rhabdoid tumors].

    PubMed

    Dainese, E; Sessa, F; Riva, C; Placidi, C; Capella, C

    2005-06-01

    Proximal type epithelioid sarcoma is a rare neoplasia in which morphological findings are characterized by nodular proliferation of epithelioid cells with focal rhabdoid features. It shares some histological features with other neoplasias and this gives an account of several differential diagnosis with other extrarenal rhabdoid tumors. Immunohistochemical and ultrastructural analysis are important in defining this entity: vimentin, cytokeratin, EMA and often CD34 expression of tumoral cells, moreover ultrastructurally evidence of large paranuclear whorls of intermediate filaments, are requested for diagnosis. A correct diagnostic framing is necessary because of the aggressive clinical behaviour of this tumor, that has a tendency to early spreading. We describe a case of vulvar proximal type epithelioid sarcoma in a 34 years old woman. PMID:16259280

  18. Velvet Vulvas at School: The Catalyzing Power of the Arts in Education

    ERIC Educational Resources Information Center

    Quinn, Therese

    2008-01-01

    As a teacher of art teachers, this author values and promotes an education through the arts that loves freedom, an education through art connected to powerful social ideas and movements, connected to social justice. This is not a kind of education common today in public schools, but it has a rich lineage. Drawing inspiration from Maxine Greene,…

  19. Adenoid Cystic Carcinoma of Bartholin’s Gland Clinically Mimics Endometriosis, A Case Report

    PubMed Central

    Akbarzadeh-Jahromi, Mojgan; Sari Aslani, Fatemeh; Omidifar, Navid; Amooee, Sedigheh

    2014-01-01

    Adenoid cystic carcinoma of Bartholin’s gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin’s glands. PMID:25429183

  20. Vulvar metastasis from carcinoma breast unveiling distant metastasis: Exploring an unusual metastatic pattern.

    PubMed

    Gandhi, Ajeet Kumar; Roy, Soumyajit; Mridha, Asit Ranjan; Sharma, Daya Nand

    2015-12-01

    A 76year old woman with a previous history of infiltrating ductal carcinoma of right breast (diagnosed and treated 14years back) presented to us with a non-healing ulcer on the left side of the vulva along with two satellite nodules close to the vulvar lesion. Biopsy showed an infiltrating ductal carcinoma of breast with a strong positivity for estrogen/progesterone receptors. Further, (18)F-FDG PET-CT (Fluoro-deoxy glucose positron emission tomography computed tomography) showed multiple bilateral lung metastases. She responded well to hormone therapy (Letrozole) with decrease in the size of primary vulvar lesion and disappearance of the satellite nodules. Repeating PET-CT at 6months showed partial response of the lung lesions. The present case is unique in the way of metastatic presentation of breast cancer to vulva after a long gap of primary diagnosis (longest reported till date) and also in unveiling of further metastatic sites in otherwise asymptomatic case. Patients (particularly elderly) with this unusual and clinically isolated pattern of metastasis might remain misdiagnosed for a long period of time and this case report aims to increase the awareness of clinicians toward the same. Gynecological surveillance remains of paramount importance in the follow up of breast cancer. PMID:26160598

  1. Metastatic Fungating Ulcerative Growth on Vulva as a Presenting Feature of Carcinoma Cervix: A Rare Case Report

    PubMed Central

    Naswa, Smriti; Marfatia, Yogesh S

    2015-01-01

    Carcinoma of the cervix is the second to fourth most common malignancy in women. It metastasizes most often to the lungs, bones, and liver. Skin involvement originating from cervical cancer is rare, even in the terminal stages of the disease. Cutaneous metastasis of cervical cancer usually presents as cutaneous nodules, papules/plaques, maculopapular rash, and diffuse inflammatory rash. We report a rare case (only the second reported case to the best of our knowledge) of a 50-year-old woman with cutaneous metastasis in form of fungating ulcerative growth on mons pubis as presenting feature of carcinoma cervix. PMID:26677276

  2. The Caenorhabditis elegans CDT-2 ubiquitin ligase is required for attenuation of EGFR signalling in vulva precursor cells

    E-print Network

    Poulin, Gino B; Ahringer, Julie

    2010-10-26

    for multiple RAS-mediated developmental signals. Embo J 2000, 19:3283-94. 34. Clark SG, Stern MJ, Horvitz HR: C. elegans cell-signalling gene sem-5 encodes a protein with SH2 and SH3 domains. Nature 1992, 356:340-4. 35. Korenjak M, Taylor-Harding B, Binne UK... ], suggesting a role in maintenance of self-renewal capacity. CDT2, a WD40 domain containing protein, was later found * Correspondence: Gino.Poulin@manchester.ac.uk 1Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road...

  3. Metastatic Fungating Ulcerative Growth on Vulva as a Presenting Feature of Carcinoma Cervix: A Rare Case Report.

    PubMed

    Naswa, Smriti; Marfatia, Yogesh S

    2015-01-01

    Carcinoma of the cervix is the second to fourth most common malignancy in women. It metastasizes most often to the lungs, bones, and liver. Skin involvement originating from cervical cancer is rare, even in the terminal stages of the disease. Cutaneous metastasis of cervical cancer usually presents as cutaneous nodules, papules/plaques, maculopapular rash, and diffuse inflammatory rash. We report a rare case (only the second reported case to the best of our knowledge) of a 50-year-old woman with cutaneous metastasis in form of fungating ulcerative growth on mons pubis as presenting feature of carcinoma cervix. PMID:26677276

  4. Sodium Tetradecyl Sulphate Direct Intralesional Sclerotherapy of Venous Malformations of the Vulva and Vagina: Report of Five Cases

    SciTech Connect

    Krokidis, Miltiadis; Venetucci, Pietro; Hatzidakis, Adam; Iaccarino, Vittorio

    2011-02-15

    We report five cases of female patients affected by symptomatic focal external genital venous malformations treated with percutaneous direct intralesional injection of sodium tetradecyl sulphate (STS). All patients were referred because of discomfort and pain when sexual intercourse was attempted. Direct sclerotherapy with 3% STS was performed on a day-hospital basis with the patient under local anesthesia. Complete resolution of the symptoms was achieved in all cases. No major adverse effects were reported. Direct intralesional sclerotherapy with STS may be considered a safe and effective method for the treatment of female external genital malformation without the necessity of general anesthesia for pain control.

  5. Vulvodynia

    MedlinePLUS

    ... to describe chronic pain or discomfort of the vulva. The vulva refers to the external female genitalia, including the ... is felt in only one place on the vulva. Vulvar vestibulitis syndrome , vestibulodynia , or simply vulvar vestibulitis ...

  6. Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

    ERIC Educational Resources Information Center

    Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

    2013-01-01

    Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

  7. Non-lesions, Misdiagnoses, Missed Diagnoses, and Other Interpretive Challenges in Fish Histopathology Studies: A Guide for Investigators, Authors, Reviewers, and Readers

    EPA Science Inventory

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negativ...

  8. Why are recurrent cervical cancers of the pelvic stump misdiagnosed as interstitial cystitis?: The urologist’s point of view based on a case report

    PubMed Central

    Oh, Jin Kyu; Kim, Khae-Hawn

    2013-01-01

    A 50-year-old female who had undergone laparoscopic total hysterectomy at a local clinic owing to leiomyoma of the uterus was referred to our hospital after having dysuria, urgency, frequency, lower abdominal pain and right flank pain over several months. After routine examinations, cystoscopy, computed tomography and magnetic resonance imaging were performed, and non-ulcerative interstitial cystitis accompanied by postoperative fibrosis secondary to a previous surgery was suggested. Pentosan sulfuric polyester (Elmiron, Alza Pharmaceuticals, Mountain View, CA) reduced her severely debilitating symptoms and improved her quality of life. Both the hydronephrosis and the symptoms were relieved by ureteral stent insertion and percutaneous nephrostomy. However, a few days later, she presented with vaginal bleeding along with her previous symptoms, and punch biopsy of the vaginal stump resulted in a diagnosis of adenocarcinoma. Both ureterocutaneostomy with radical cystectomy and lower anterior resection for rectum invasion were conducted. After the slide review of the original specimen from the local clinic, she was diagnosed with recurrent cervical cancer of the vaginal stump. PMID:23766840

  9. Behavioral and Movement Disorders due to Long-Lasting Myoclonic Status Epilepticus Misdiagnosed as ADHD in a Patient With Juvenile Myoclonic Epilepsy: Electroclinical Findings and Related Hemodynamic Changes.

    PubMed

    Fanella, Martina; Carnì, Marco; Morano, Alessandra; Albini, Mariarita; Lapenta, Leonardo; Casciato, Sara; Fattouch, Jinane; Di Castro, Elisabetta; Colonnese, Claudio; Vaudano, Anna Elisabetta; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2016-01-01

    Epilepsy and attention-deficit/hyperactivity disorder (ADHD) likely share common underlying neural mechanisms, as often suggested by both the evidence of electroencephalography (EEG) abnormalities in ADHD patients without epilepsy and the coexistence of these 2 conditions. The differential diagnosis between epilepsy and ADHD may consequently be challenging. In this report, we describe a patient presenting with a clinical association of "tics" and behavioral disorders that appeared 6 months before our first observation and had previously been interpreted as ADHD. A video-EEG evaluation documented an electroclinical pattern of myoclonic status epilepticus. On the basis of the revised clinical data, the EEG findings, the good response to valproate, the long-lasting myoclonic status epilepticus, and the enduring epileptic abnormalities likely causing behavioral disturbances, the patient's symptoms were interpreted as being the expression of untreated juvenile myoclonic epilepsy. The EEG-functional magnetic resonance imaging study revealed, during clinical generalized spike-and-wave and polyspike-and-wave discharges, positive blood oxygen level-dependent (BOLD) signal changes bilaterally in the thalamus, the prefrontal cortex (Brodmann area 6, supplementary motor area) and the cerebellum, and negative BOLD signal changes in the regions of the default mode network. Such findings, which are typical of BOLD changes observed in idiopathic generalized epilepsy, may also shed light on the anatomofunctional network underlying ADHD. PMID:25733678

  10. Childhood lichen sclerosus--a challenge for clinicians.

    PubMed

    Lagerstedt, Maria; Karvinen, Kaisa; Joki-Erkkilä, Minna; Huotari-Orava, Riitta; Snellman, Erna; Laasanen, Satu-Leena

    2013-01-01

    Childhood lichen sclerosus (LS) is a rare and often misdiagnosed inflammatory dermatitis with an unpredictable course. The complications of LS are architectural changes of the vulva; malignant transformation is possible. The objective of our study was to define the background and the long-term course of childhood LS. A registery study identified 44 children with LS treated at Tampere University Hospital, Tampere, Finland, from 1982 to 2010. A questionnaire was sent to the identified patients and 15 responded. The clinical depiction of LS varied significantly. LS was diagnosed in only 16% of the patients at the referring unit. Autoimmune disorders were observed in 6 of the 44 patients. High prevalences of Turner's syndrome (2/44) and kidney disease (2/44) were noted. The majority of the patients were treated with topical corticosteroids. Eight developed architectural changes of the vulva. The questionnaire revealed that three of six patients who were asymptomatic at the end of the registery study follow-up experienced a recurrence of symptoms. None of them were undergoing follow-up. Nine of the 15 patients reported reduced quality of life. Childhood LS is a heterogeneous disease with a remarkable effect on quality of life. The misdiagnosis of childhood LS is common. The association between LS and autoimmune diseases should be noted. The high prevalence of Turner's syndrome raises questions regarding the influence of low estrogen levels on the development of LS. The prognosis cannot be predicted, so long-term follow-up is recommended. New tools for diagnosis and surveillance are needed. PMID:23437870

  11. A fibromyxoid stromal response is associated with an infiltrative tumor morphology, perineural invasion, and lymph node metastasis in squamous cell carcinoma of the vulva.

    PubMed

    Jeffus, Susanne K; Gehlot, Ashita; Holthoff, Emily; Stone, Rebecca; Spencer, Horace; Kelly, Thomas; Post, Steven R; Quick, Charles M

    2015-09-01

    Patterns of invasion and stromal response are understudied in vulvar squamous cell carcinoma. The aim of this study was to explore whether histologic features such as an infiltrative pattern of invasion and fibromyxoid stromal response (FMX-SR) are meaningful prognostic factors. We reviewed 143 vulvar squamous cell carcinoma resections and correlated patterns of invasion and stromal response with patient age, ethnicity, depth of invasion, tumor size, perineural invasion (S100/AE1/3 stain), lymph node involvement (LNI), extranodal extension, margin status, pathologic stage, and recurrence. Univariate analyses of continuous variables were performed using t tests, whereas Pearson ? tests were used for categorical variables. Logistic regression analyses examined the relationship between histopathologic characteristics and clinical outcomes. There was a statistically significant association between infiltrative tumors and an FMX-SR in comparison with noninfiltrative tumors (P<0.001). Tumors with FMX-SR were significantly more deeply invasive (P=0.0025) and more likely to have LNI (P=0.0364), extranodal extension (P=0.0227), and perineural invasion (P=0.0011) compared with tumors without FMX-SR. For cases with negative surgical margins, the association between tumors with FMX-SR and LNI was significantly strengthened (odds ratio=4.73, P=0.0042), even after adjustments for age, race, and depth of invasion (odds ratio=4.34, P=0.0154). The presence of both FMX-SR and an infiltrative pattern of invasion in tumors with negative margins was significantly associated with LNI (P=0.0235) and recurrence (P=0.0124). These results suggest that interactions between nerve, tumor, and stromal cells play a role in tumor progression and represent additional prognostic factors that help stratify those patients at highest risk for LNI, extranodal extension, and recurrence. PMID:26274029

  12. General Information about Vulvar Cancer

    MedlinePLUS

    ... cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva. Vulvar ... diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other ...

  13. Vulvar Cancer

    MedlinePLUS

    ... Vulvar Cancer Overview What is vulvar cancer? The vulva is the skin and fatty tissue between the ... inch below the pubic hairline. Cancer of the vulva most often affects the two skin folds (or ...

  14. Lymphogranuloma venereum

    MedlinePLUS

    ... lymph nodes in the groin Swelling of the vulva or labia in women Swollen lymph nodes in ... Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. ...

  15. Bartholin cyst or abscess

    MedlinePLUS

    ... and swollen. Activity that puts pressure on the vulva , and walking and sitting, may cause severe pain. ... Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. ...

  16. Vaginal itching and discharge - Adult and adolescent

    MedlinePLUS

    ... skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It ... blisters or other sores on your vagina or vulva. Have burning with urination or other urinary symptoms. ...

  17. Vulvodynia

    MedlinePLUS

    ... chronic (long-lasting) pain and discomfort of the vulva that is not caused by an infection, skin ... is felt on a specific area of the vulva. What is vulvar vestibulitis syndrome (VVS)? Vulvar vestibulitis ...

  18. Dealing with Sexual Problems

    MedlinePLUS

    ... cystectomy Abdominoperineal resection Surgery for cancer of the vulva (vulvectomy) Pelvic exenteration Sex and pelvic radiation therapy ... for intercourse has changed. If your vagina or vulva has been affected by surgery, you will need ...

  19. 28 CFR 115.6 - Definitions related to sexual abuse.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...to consent or refuse: (1) Contact between the penis and the vulva or the penis and the anus, including penetration, however slight; (2) Contact between the mouth and the penis, vulva, or anus; (3) Penetration of...

  20. Body Odor (For Girls)

    MedlinePLUS

    ... sweat glands between your legs and on your vulva. They also become more active during puberty. This ... buy special products to clean it. Washing your vulva and around your vaginal area with mild soap ...

  1. Treatment Options by Stage (Vulvar Cancer)

    MedlinePLUS

    ... cancer) cells form in the tissues of the vulva. Vulvar cancer forms in a woman's external genitalia . ... in the vulvar area. Tests that examine the vulva are used to detect (find) and diagnose vulvar ...

  2. Treatment Option Overview (Vulvar Cancer)

    MedlinePLUS

    ... cancer) cells form in the tissues of the vulva. Vulvar cancer forms in a woman's external genitalia . ... in the vulvar area. Tests that examine the vulva are used to detect (find) and diagnose vulvar ...

  3. 76 FR 75458 - Servicemembers' Group Life Insurance Traumatic Injury Protection Program-Genitourinary Losses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ...20(f)(19) anatomical loss of the vulva, uterus, or vaginal canal and permanent loss of use of the vulva or vaginal canal. A TSGLI benefit of...payable for either the anatomical loss of the vulva, uterus, or vaginal canal or for...

  4. Your First Gynecologic Visit

    MedlinePLUS

    ... In this exam, the doctor looks at the vulva . He or she may give you a mirror so that you can look at the vulva as well. This exam is a good way ... exam has three parts: 1. Looking at the vulva 2. Looking at the vagina and cervix with ...

  5. Intradermal spitz nevi: a rare subtype of spitz nevi analyzed in a clinicopathologic study of 74 cases.

    PubMed

    Plaza, Jose A; De Stefano, Danielle; Suster, Saul; Prieto, Victor G; Kacerovska, Denisa; Michal, Michal; Sangueza, Martin; Kazakov, Dmitry V

    2014-04-01

    Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patients' ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis. PMID:24736667

  6. Wnt and EGF pathways act together to induce C. elegans male hook development

    E-print Network

    Sternberg, Paul W.

    Comparative studies of vulva development between Caenorhabditis elegans and other nematode species have provided some insight into the evolution of patterning networks. However, molecular genetic details are available ...

  7. An Unusual Cause of a Breast Mass in a Patient from China.

    PubMed

    Nathavitharana, Ruvandhi R; Fleischmann-Rose, Kristin; Yassa, David S; Wertheimer, Michael D; Alonso, Carolyn D

    2015-08-01

    Sparganosis is a parasitic infection caused by Spirometra spp. and often presents as a subcutaneous swelling, most commonly noticed in the abdominal wall or extremities. Amphibians such as frogs ingest infected copepods (crustaceans that have ingested coracidia, i.e., Spirometra spp. embryos) and serve as a secondary intermediate host. Complete surgical excision is recommended for definitive diagnosis and treatment. Granulomatous inflammation is the most common histologic finding. Although dissemination can occur, most cases are localized. Serum enzyme-linked immunosorbent assay (ELISA) has been suggested as a potential surveillance tool. Medical therapy with antiparasitic agents, such as praziquantel, is not typically recommended but may be effective at high doses. Preventing recurrence thus depends on adequate surgical removal of the parasite. We report a case of a breast mass caused by sparganosis infection in a Chinese female whose likely exposure was due to frog consumption. The diagnosis was confirmed on surgical excision and no systemic antiparasitic therapy was required. PMID:26033021

  8. March 2008The Monthly InSTALLment Brought to you by the UHS Health Promotion Office 110 Anderson Tower 273-5775

    E-print Network

    Cantlon, Jessica F.

    , cervix, vagina, anus, vulva, head of the penis, mouth, and throat. There are more than 100 different warts!" Genital warts typically appear on the vulva, vagina, cervix, penis, or anus. They are usually on their own and are linked to cervical cancer. In males, high risk HPV infection may cause cancer of the penis

  9. Lichen Sclerosis

    MedlinePLUS

    ... a rare skin condition that usually affects the vulva and anal areas in young girls, adolescents, and adults, but it’s more common before puberty and after menopause. Similar to other skin conditions, there are treatments ... that makes the vulva look white, slightly shiny, and smooth. The skin’s ...

  10. Intrauterine temperatures of mares under different management conditions 

    E-print Network

    Commaille, Lynn Frances

    2009-05-15

    , with the suture hanging out of the vulva. Prior to this, the mare?s vulva and perineal area had been washed with a diluted Betadine scrub (Purdue Pharma, L.P., Stamford, Connecticut, 06901). Temperatures were recorded by the uterine device for 5 d; if at any...

  11. An Unusual Gross Appearance of Vulval Tuberculosis Masquerading as Tumor

    PubMed Central

    Arakeri, Surekha U.

    2014-01-01

    Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized. PMID:25298898

  12. Pulmonary cryptococcosis presenting as acute severe respiratory distress in a newly diagnosed HIV patient in Tanzania: a case report.

    PubMed

    Gunda, Daniel W; Bakshi, Fatma A; Rambau, Peter; Kilonzo, Semvua B

    2015-09-01

    Pulmonary cryptococcosis is a common condition in HIV-infected patients which is frequently missed or misdiagnosed in resource-limited countries. We report a case of HIV/AIDS patient who was misdiagnosed with a fatal outcome. There is a need to implement screening tools to be used where the diagnosis may not be confirmed. PMID:26401280

  13. Pulmonary cryptococcosis presenting as acute severe respiratory distress in a newly diagnosed HIV patient in Tanzania: a case report

    PubMed Central

    Gunda, Daniel W; Bakshi, Fatma A; Rambau, Peter; Kilonzo, Semvua B

    2015-01-01

    Key Clinical Message Pulmonary cryptococcosis is a common condition in HIV-infected patients which is frequently missed or misdiagnosed in resource-limited countries. We report a case of HIV/AIDS patient who was misdiagnosed with a fatal outcome. There is a need to implement screening tools to be used where the diagnosis may not be confirmed. PMID:26401280

  14. Stages of Vulvar Cancer

    MedlinePLUS

    ... are found on the surface of the vulvar skin. These abnormal cells are not cancer . Vulvar intraepithelial ... vulva : Skinning vulvectomy : The top layer of vulvar skin where the cancer is found is removed. Skin ...

  15. Do We Know What Causes Vulvar Cancer?

    MedlinePLUS

    ... Next Topic Can vulvar cancer be prevented? Do we know what causes vulvar cancer? Several risk factors ... cancer of the vulva have been identified, and we are beginning to understand how these factors can ...

  16. Too Few Preteen Girls Get HPV Vaccine, CDC Says

    MedlinePLUS

    ... vaccine protects against infection with the sexually transmitted human papillomavirus (HPV), which can cause cancers of the cervix, vulva, vagina and anus. "Increasing delivery of HPV vaccination at the recommended ages of 11 or ...

  17. Vulvar Care

    MedlinePLUS

    ... A make up remover that contains mineral oil, petroleum jelly, and paraffin also can be used (example: ... washcloth and put it against your vulva. Refrigerated petroleum jelly (Vaseline) and cold plain yogurt put on ...

  18. Adenomyosis

    MedlinePLUS

    Katz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology . 6th ed. Philadelphia, PA: Elsevier ...

  19. Transvaginal ultrasound

    MedlinePLUS

    ... In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology . 6th ed. Philadelphia, PA: Elsevier Mosby; 2012: chap 33. Katz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ...

  20. Vaginal itching and discharge - child

    MedlinePLUS

    Pruritus vulvae; Itching - vaginal area; Vulvar itching ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, and sprays ...

  1. HIV, AIDS, and Older People

    MedlinePLUS

    ... at risk if: You had sex without a latex or polyurethane condom. The virus passes from the ... of the vagina, vulva, penis, rectum, or mouth. Latex condoms can help prevent an infected person from ...

  2. What Is Vulvar Cancer?

    MedlinePLUS

    ... Bartholin glands less often. Types of vulvar cancer Squamous cell carcinomas Most cancers of the vulva are squamous cell ... of skin cells. There are several subtypes of squamous cell carcinoma: The keratinizing type is most common, and usually ...

  3. Postpartum Blood Clots

    MedlinePLUS

    ... leg consists of warm compresses (to reduce discomfort), compression bandages applied by a doctor or nurse, and ... Cancer of the vulva Am I Correct? More Videos Health Day News Better Sex Life May Be ...

  4. Vulvodynia

    MedlinePLUS

    ... link in the menu on the left. Common Names Vulvodynia Vulvar pain (chronic pain or discomfort of the vulva) Medical or Scientific Names Vulvodynia Vulvar vestibulitis Last Reviewed: 04/22/2013 ...

  5. Penstemon tenuis (Cultivated ) 

    E-print Network

    David C. Reed

    2011-08-10

    not engaged in mating the male, like the hermaphrodite, explores his environment with predominantly forward locomotion. However, when the male contacts a potential mate he immediately places his tail against her surface and searches for the vulva, moving...

  6. Molluscum Contagiosum

    MedlinePLUS

    ... bumps on your genital area such as your vulva, inner thighs, buttocks and you’re sexually active; ... CYWH) is a collaboration between the Division of Adolescent and Young Adult Medicine and the Division of ...

  7. Ultrasonography findings of vulvar liposarcoma. Case report.

    PubMed

    Yanik, Bahar; Inceboz, Umit; Bulbul, Erdogan; Demirpolat, Gulen; Uzgoren, Ismail Engin

    2015-09-01

    Liposarcoma (LPS) of vulva is a rare entity. We present the ultrasonographic (US) and color Doppler ultrasonographic (CDUS) findings of a vulvar myxoid LPS. Although LPS cases have been reported in the extremities and trunk, the US or CDUS findings of LPS in vulva have not been described previously. On US the mass appeared as a well-defined, homogeneous hypoechoic structure and on CDUS it was quite hypervascular. PMID:26343091

  8. Syringocystadenoma papilliferum in an unusual location*

    PubMed Central

    Nascimento, Bianca Angelina Macêdodo; Carneiro, Clívia Maria Oliveira; Carvalho, Alessandra Haber; Bittencourt, Maraya de Jesus Semblano; Drago, Marion Guimarães; Freitas, Lívia Karlla Marinho

    2015-01-01

    Syringocystadenoma papilliferum is a rare benign hamartomatous adnexal tumor of the apocrine or eccrine sweat glands. Most patients present a solitary lesion in the head and neck region. Presentation outside the head and neck region is even more uncommon. We present a case of Syringocystadenoma papilliferum with papulonodular lesion located on the vulva of an infant girl. This case illustrates the atypical location of this rare disease and adds to the differential diagnosis of lesions on the vulva.

  9. Neuroparasitic Infections: Cestodes, Trematodes, and Protozoans

    PubMed Central

    Walker, M.D.; Zunt, J.R.

    2009-01-01

    Parasitic infection of the nervous system can produce a variety of symptoms and signs. Because symptoms of infection are often mild or nonspecific, diagnosis can be difficult. Familiarity with basic epidemiological characteristics and distinguishing radiographic findings can increase the likelihood of detection and proper treatment of parasitic infection of the nervous system. This article discusses the clinical presentation, diagnosis, and treatment for some of the more common infections of the nervous system caused by cestodes, trematodes and protozoans: Echinococcus spp., Spirometra spp. (sparganosis), Paragonimus spp., Schistosoma spp., Trypanosoma spp., Naegleria fowlerii, Acanthamoeba histolytica, and Balamuthia mandrillaris. PMID:16170739

  10. Pentastomiasis and other parasitic zoonoses from reptiles and amphibians.

    PubMed

    Pantchev, Nikola; Tappe, Dennis

    2011-01-01

    Reptiles are growing in popularity as pets.The colonization of reptiles and amphibians by parasites and the resulting disease conditions are the most common problems seen in captive animals.This review focuses on pentastomiasis and sparganosis, important parasitic zoonoses of reptiles and amphibians, respectively, and free living-amoebae. Humans are suitable accidental hosts for some pentastomid species (particularly Armillifer and Porocephalus). In geographical areas with special ethnics, such as in West and Central Africa, and East Asia, 8-45% of the human population can be affected. Usually the larvae are coincidentally found during abdominal surgeries. However, fatalities have been described. Extreme caution is necessary when handling infected reptiles. Ocular or cerebral sparganosis is not uncommonly found in humans in East Asia. This disease is caused by spargana, tapeworm larvae (plerocercoids) of Spirometra sp. The infection occurs when uncooked meat from reptiles or amphibians is applied to wounds or eyes and the parasites migrate directly to human tissue, or by consumption of contaminated food or water. As a consequence of the reptile's predatory behaviour, the full spectrum of endo- and ectoparasites from potential prey animals can be found as transiting parasites in the intestinal tract, e. g. Hymenolepis nana, Cryptosporidium (C.) muris, C parvum or Capillaria hepatica. Occasionally, free-living amoebae are also found in reptile faeces (Acanthamoeba, Naegleria, Hartmanella, Vahlkampfia or Echinamoeba sp.). PMID:22191176

  11. Characterisation of the relationship between Spirometra erinaceieuropaei and Diphyllobothrium species using complete cytb and cox1 genes.

    PubMed

    Zhang, Xi; Wang, Han; Cui, Jing; Jiang, Peng; Fu, Guo Mei; Zhong, Kan; Zhang, Zi Fang; Wang, Zhong Quan

    2015-10-01

    Spirometra erinaceieuropaei is an important diphyllobothriid cestode whose larval plerocercoid (sparganum) can parasitise humans, causing sparganosis. In China, sparganosis is an important foodborne parasitic zoonosis and poses a serious threat to human health. However, our knowledge of the taxonomic classification of S. erinaceieuropaei and its relationship with other diphyllobothriid cestodes, such as Diphyllobothrium, remains fragmentary. In this study, we determined the complete sequences of cytochrome b (cytb) and cytochrome c oxidase subunit I (cox1) genes from 61 isolates of S. erinaceieuropaei collected from 11 geographical locations in eastern China and compared them to the sequences of Diphyllobothrium species from the GenBank database. Then, we evaluated the genetic variation of S. erinaceieuropaei and the phylogenetic relationship between S. erinaceieuropaei and Diphyllobothrium. Both negative Tajima's D and Fu's FS values of neutrality tests and unimodal curve of mismatch distribution analyses supported demographic population expansion. Bayesian skyline plot (BSP) analyses indicated that a population expansion occurred in the Pleistocene. Phylogenetic analysis based on cytb, cox1, and cytb+cox1 under all three methods tested (neighbour-joining, maximum parsimony, and maximum likelihood) suggested that the S. erinaceieuropaei isolates from eastern China and the genus Diphyllobothrium are separate monophyletic groups. Furthermore, the uncorrelated log-normal relaxed molecular-clock model suggested that divergence between Spirometra and Diphyllobothrium began in the late Miocene. PMID:26205687

  12. Giant Vulvar Epidermoid Cyst in an Adolescent Girl

    PubMed Central

    Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin

    2015-01-01

    Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11?cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839

  13. Giant vulvar epidermoid cyst in an adolescent girl.

    PubMed

    Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin

    2015-01-01

    Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11?cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839

  14. Vertebral Hemangiolymphangioma Mimics Bone Metastases on 99mTc-MDP SPECT/CT.

    PubMed

    Zhang, Yiqiu; Li, Beilei; Shi, Hongcheng; Cai, Liang; Hou, Jun

    2016-01-01

    Hemangiolymphangioma is a very rare, congenital malformation of both lymphatic and blood vessels. In the present study, we report a case of vertebral hemangiolymphangioma that was misdiagnosed as bone metastasis on Tc-MDP SPECT/CT. PMID:26359559

  15. 75 FR 28621 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ...gender, and family history) associated with the disease; and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

  16. 75 FR 69086 - Agency Forms Undergoing Paperwork Reduction Act Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ...family history of individuals diagnosed with the disease); and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

  17. Quit Obsessing!

    ERIC Educational Resources Information Center

    Schlozman, Steven C.

    2002-01-01

    Asserts the obsessive-compulsive disorder is often misdiagnosed in children and adolescents; describes characteristics of obsessive-compulsive disorder; differentiates between normal and abnormal obsessions; suggests ways teachers can help students diagnosed with the disorder. (PKP)

  18. For Immediate Release --Thursday, April 30, 2015 Experts available -University of Lethbridge researchers

    E-print Network

    Morris, Joy

    's depression. The U of L has a great breadth of research expertise available the impact that perceived masculinities have on the rates of depression in men. Kellett believes that many men who suffer depression are misdiagnosed and, even

  19. Iatrogenic Cushing's Disease in a Boy after Misdiagnosis of Salt-Losing Virilizing Adrenal Hyperplasia: Impaired Metyrapone Response with Failure of Catch-Up Growth

    ERIC Educational Resources Information Center

    Mendilaharzu, Hernan; And Others

    1973-01-01

    A boy misdiagnosed as having the sodium-losing form of virilizing adrenal hyperplasia was treated with large doses of glucocorticoids and mineralocorticoids from the newborn period until he was more than 4 years of age. (Author)

  20. The emergence of mecC methicillin-resistant Staphylococcus aureus

    E-print Network

    Paterson, Gavin K.; Harrison, Ewan M.; Holmes, Mark A.

    2013-11-12

    The report of methicillin-resistant Staphylococcus aureus (MRSA) encoding a divergent mecA gene in 2011 was highly significant. This homologue, designated mecC, poses diagnostic problems with the potential to be misdiagnosed as methicillin...

  1. Calcium pyrophosphate arthritis

    MedlinePLUS

    ... that can cause attacks of arthritis . Like with gout, crystals form in the joints. But in calcium ... pyrophosphate arthritis can be misdiagnosed as: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis

  2. Chronic Fatigue Syndrome (CFS): Symptoms

    MedlinePLUS

    ... message, please visit this page: About CDC.gov . Chronic Fatigue Syndrome (CFS) Share Compartir Symptoms On this Page Primary ... Other Symptoms What's the Clinical Course of CFS? Chronic fatigue syndrome can be misdiagnosed or overlooked because its symptoms ...

  3. Vulvar syringoma, report of a case and review of the literature.

    PubMed Central

    Miranda, José J.; Shahabi, Shorheh; Salih, Sanah; Bahtiyar, Ozan M.

    2002-01-01

    Syringomas are common intraepidermal sweat gland tumors most often found in women around the time of adolescence. Frequent sites of involvement include the lower eyelids and malar areas, however vulvar involvement is relatively rare. These lesions often present as small, multiple, skin-colored-to-yellowish papules and are often associated with increased vulvar discomfort and itching. We present a case of a 29-year old female who presented to her gynecologist complaining of vulvar itching and burning. A small condylomatous-type wart observed on her vulva was biopsied and found to be a syringoma. Because of their clinical presentation and associated symptoms, vulvar syringomas should be considered in the differential diagnosis of any multicentric papular lesion of the vulva, vulvar pain syndrome, and pruritis vulvae. PMID:12784970

  4. Acute genital ulcers.

    PubMed

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  5. Psychosexual Aspects of Vulvar Disease.

    PubMed

    Rosenbaum, Talli Y; Barnard, Ellen; Wilhite, Myrtle

    2015-09-01

    Physically, the vulva is an anatomic location of convergence, which includes vascular, neural, hormonal, reproductive, dermatologic, and musculoskeletal systems. Psychosocially, the vulva represents privacy, femininity, sexuality, and intimacy. Because of this intertwined relationship, vulvar disease and dysfunction can significantly impact a woman's physical health as well as her relationships. This article elucidates the impact of vulvar disease on the individual psyche, sexual functioning, and intimate relationships. Psychological concepts are explained, psychological interventions are reviewed, and integrative approaches addressing psychological factors in the clinic are introduced. PMID:26125964

  6. Mucocutaneous manifestations of helminth infections: Trematodes and cestodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Bravo, Francisco; Giglio, Patricia; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased international travel for vacation, work, and medical missions and immigration into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. It has been estimated that 20% to 70% of international travelers suffer from some travel-related health problem. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on cutaneous diseases caused by helminth infections. Part I of the review focused on nematode infections; part II will focus on trematode and cestode infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568338

  7. Mucocutaneous manifestations of helminth infections: Nematodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Pino, Livia; Bravo, Francisco; Giglio, Patricia; Sethi, Aisha; Klaus, Sidney; Sangueza, Omar P; Fuller, Claire; Mendoza, Natalia; Ladizinski, Barry; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568337

  8. [Intestinal Perforation Due To Infection Of Sparganum Mansoni

    PubMed

    Min, Hong Ki; Han, Sang Ho; Yoon, Sei Ok; Oh, Chang Hyun

    1976-06-01

    In May 1974, authors encountered a 37 year old Korean male who was suffering from very serious condition of acute abdomen. On exploratory laparotomy, a ruptured granulomatous mass in the proximal portion of the ileum showing extensive inflammatory and gangrenous changes was found and about 4 ft. long of the bowel was resected. From the honey-combed fibrous capsules in the mass, four plerocercoid larvae, spargana, measuring about 3 to 7 cm in lengths were extirpated. The patient had a past history of having eaten the raw flesh of a snake as a tonic about 7 months prior to admission. Four cases of intra-abdominal sparganosis reported previously in Korea and the present case were discussed briefly. Snakes and frogs in Korea are very important second intermediate hosts for the 1arva, Sparganum stage. It is most preferable that the habitual ingestion of the raw fleshes of them should be avoided in this country. PMID:12913452

  9. Evaluation of the Role of Vibrational Spectroscopy in the Assessment of Vulval Disease

    ClinicalTrials.gov

    2014-08-21

    Normal Vulval Skin; Lichen Sclerosus; High Grade Dysplasia - Usual Type ('VIN 2-3'); High Grade Dysplasia - Differentiated Type ('VIN 2-3'); Squamous Cell Carcinoma; Epithelial Hyperplasia Without Atypia; Atypia Not Otherwise Specified/ Low Grade Dysplasia ('VIN 1'); Pagets Disease of the Vulva

  10. Morphological and molecular characterization of Pratylenchus lentis n. sp. (Nematoda: Pratylenchidae) from Sicily

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pratylenchus lentis n. sp. parasitizing roots of lentil in Sicily, Italy, is described and illustrated. The new species is characterized by a high lip region with three annuli, stylet mean length of 16 micrometers with anteriorly flattened knobs, cylindrical body with a relatively anterior vulva, l...

  11. On the description of two new species of Paurodontella (Nematoda: Paurodontinae) with a key and diagnostic compendium to the species of the genus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Two new species of Paurodontella collected around the roots of wheat (Triticum aestivum L.) are described and illustrated. One new species is characterized by having a short cylindrical, robust body markedly tapering at both ends with an anteriorly located vulva, short post-uterine sac, lateral fiel...

  12. 21 CFR 884.5390 - Perineal heater.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...to apply heat directly by contact, or indirectly from a radiant source, to the surface of the perineum (the area between the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the vulvar orifice for...

  13. 21 CFR 884.5390 - Perineal heater.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...to apply heat directly by contact, or indirectly from a radiant source, to the surface of the perineum (the area between the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the vulvar orifice for...

  14. Urogenital tumors

    SciTech Connect

    Weller, R.E.

    1994-03-01

    An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

  15. RESMDD'02 Radiation in Life Sciences: Hartmut F.-W. Sadrozinski , SCIPP Radiation Effects in

    E-print Network

    California at Santa Cruz, University of

    RESMDD'02 Radiation in Life Sciences: Hartmut F.-W. Sadrozinski , SCIPP SCIPPSCIPP Radiation Effects in Life Sciences oocyte eggs in uterus spermatheca gonad vulva Quality of Radiation Biological Radiation in Life Sciences: Hartmut F.-W. Sadrozinski , SCIPP SCIPPSCIPP Radiation in Life Sciences Why

  16. Morphology and Anatomy of the Practical in Zoology

    E-print Network

    Airoldi, Jean-Pierre

    ) masticatory muscles and salivary glands masseter digastricus vena jugularis externa submaxillary glands parotid gland sublingual glands #12;Digestive system Organs in situ liver xiphoid cartilage caecum ­ Thymus ­ Lungs thymus heart right lungs left diaphragma #12;Urogenital system: female anus vulva (vaginal

  17. 10.1101/gad.8.2.160Access the most recent version at doi: 1994 8: 160-173Genes Dev.

    E-print Network

    Kornfeld, S. Kerry

    the nearest Pn.p cell (P6.p) to generate eight daughter cell nuclei that contribute to the vulva (the 1° cell fate). The next nearest Pn.p cells (P5.p and P7.p) each generate seven daughter cell nuclei that con Kornfeld, L M Miller, et al. induction of vulval cell fates in Caenorhabditis elegans. A MAP kinase homolog

  18. Characterization of a New Species of Cyst Nematode Parasitizing Corn

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Examination of soil around unthrifty corn roots in northwestern Tennessee (Obion County) in 2006 revealed high population densities of juvenile nematodes and lemon-shaped cysts. This nematode resembles Cactodera spp. in possessing a circumfenestrate vulva but lacking bullae and an underbridge. These...

  19. Traumatic Vulvar Epithelial Inclusion Cysts Following Female Genital Mutilation (FGM)

    PubMed Central

    Mack-Detlefsen, B.; Banaschak, S.; Boemers, T. M.

    2015-01-01

    Background: Female genital mutilation (FGM) occurs mainly in Africa, parts of the Arabian Peninsula and parts of Asia. It is commonly associated with acute complications as well as diverse late/delayed complications. One of the most common of these late complications is progressively enlarging painless cysts of the vulva. Case Report: An 8-year-old girl from Eritrea presented to our paediatric emergency department with a progressively enlarging mass of the vulva. She had undergone a clitoridectomy and partial removal of the labia minora as an infant in Eritrea. We performed surgical excision of the cyst and reconstruction of the labia. Histology showed a traumatic squamous epithelial inclusion cyst of the vulva. Conclusion: Epithelial or dermoid cysts of the vulva following FGM are extremely rare. Symptoms often require surgical intervention. Through increasing migration, more girls and female youths with FGM are likely to present to practices and hospitals in Germany. Thus increased knowledge and awareness of the medical complications of FGM and their treatment will be necessary in years to come. PMID:26500372

  20. What Are the Symptoms of Pelvic Pain?

    MedlinePLUS

    ... such as going to work, exercising, or having sex. Women describe pelvic pain in many ways. Pelvic pain ... some feel pain when lifting something heavy. Some women have pain in the vulva (the ... during sex or when inserting a tampon. 1 , 2 International ...

  1. Copyright 2007 by the Genetics Society of America DOI: 10.1534/genetics.106.069633

    E-print Network

    Horvitz, H. Robert

    chromatin structure can lead to developmental defects in numer- ous organisms (reviewed by Margueron et al conserved pro- teins important for signal transduction, chromatin re- modeling, and transcriptional repression. The vulva of the C. elegans hermaphrodite is formed from three of six equipotent blast cells, P3

  2. IEEE NSS/MIC 2003 N30-3 Hartmut F.-W. Sadrozinski , SCIPP, UC Santa Cruz The Particle Tracking Silicon

    E-print Network

    California at Santa Cruz, University of

    Silicon Microscope PTSM oocyte eggs in uterus spermatheca gonad vulva M. Ebrahimi, M. Bruzzi, J. Feldt, B/MIC 2003 N30-3 Hartmut F.-W. Sadrozinski , SCIPP, UC Santa Cruz Particle Tracking Silicon Microscope (PTSM ­ support of DOE and NASA low-dose research programs Implementation is based on Silicon Microstrip Detectors

  3. Giant vulvar lipoma in an adolescent girl: a case study and literature review.

    PubMed

    Jó?wik, Maciej; Ko?odziejczak, Ma?gorzata; Klonowska-Dziatkiewicz, Ewa; Jó?wik, Marcin

    2014-10-01

    A rare case of a giant vulvar lipoma that developed in an adolescent is presented. A review of the world literature of 15 cases that occurred prior to adulthood confirmed that they tend to occur on the right side of the vulva. PMID:24629715

  4. Facial Involuntary Movements and Respiratory Failure in CANOMAD, Responsive to IVIG Therapy

    PubMed Central

    Johnson, Kate; Malkan, Ashish; Shaffi, Mohamed

    2015-01-01

    CANOMAD is a rare chronic neuropathy, characterized by chronic sensory ataxia and intermittent brain stem symptoms due to antidisialosyl antibodies. The disorder results in significant morbidity but is poorly understood and often misdiagnosed. We describe a unique case of CANOMAD, associated with involuntary movements of the face; patient reported exacerbations with citrus and chocolate and respiratory muscle weakness. Our patient was initially misdiagnosed with Miller Fisher Syndrome, highlighting the need for vigilance should neurological symptoms recur in patients initially diagnosed with a Guillain Barre variant. Moreover, the optimal treatment is unknown. This patient responded remarkably to intravenous immunoglobulin and has been maintained on this treatment, without further exacerbations. PMID:26697071

  5. Cleidocranial dysplasia syndrome (CCD) with an unusual finding in a young patient.

    PubMed

    Singhal, Parul; Singhal, Anita; Jayam, Cheranjeevi; Bandlapalli, Anila

    2015-01-01

    Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1?000?000 individuals, presents with a wide range of variability. Dentists are often the first to encounter patients with CCD, some of whom do not show typical manifestations. Since it has similar features to other pathologies, CCD is misdiagnosed as other conditions. A 10-year-old boy suffering from CCD was misdiagnosed as having rickets and was referred for non-eruption of a few permanent teeth along with an unaesthetic facial appearance. Clinically and radiologically, a diagnosis of CCD was made. Currently, management of this patient's orofacial manifestations is underway. PMID:26581700

  6. Abdominal scar endometriosis after Caesarean section: a rare entity.

    PubMed

    Sinha, Ruchi; Kumar, Mohan; Matah, Manjari

    2011-01-01

    Scar endometriosis is an uncommon entity. It is often misdiagnosed leading to unnecessary referrals. Gynaecologists and general surgeons must be aware of this entity to avoid discomfort to the patient due to delay in diagnosis. We are presenting a case of scar endometriosis which was misdiagnosed initially. Detailed history of cyclic pain and swelling was the key point for the final diagnosis of scar endometriosis. Medical therapy was ineffective. Surgical excision of mass was the treatment for endometriotic lesion. This article is an attempt to create awareness of this condition among gynaecologists and general surgeons. PMID:23393503

  7. Diarrhea as initial manifestation of pulmonary artery intimal sarcoma: a case report and literature review

    PubMed Central

    Xu, Xiaoling; Zhang, Ruifeng; Hu, Huihui; Ye, Wu; Wang, Jin; Chen, Liying; Qiu, Lijun; Ying, Kejing

    2015-01-01

    Pulmonary artery intimal sarcoma (PAIS) is a rare malignant tumor that presents with nonspecific symptoms and may be misdiagnosed as thromboembolic disease. We report a case of a 40-year-old female who presented with diarrhea as the initial symptom, was misdiagnosed and received thrombolytic therapy for presumed pulmonary embolism. Progressive symptoms and subsequent surgery led to the diagnosis of PAIS, and early relapse after pulmonary endarterectomy. Her survival time was 17 months after pulmonary endarterectomy. To our knowledge, diarrhea as initial manifestation of PAIS has not been described. PMID:26425101

  8. Effects of Feeding Barley Naturally Contaminated with Fusarium Mycotoxins on Growth Performance, Nutrient Digestibility, and Blood Chemistry of Gilts and Growth Recoveries by Feeding a Non-contaminated Diet

    PubMed Central

    Kong, C.; Shin, S. Y.; Park, C. S.; Kim, B. G.

    2015-01-01

    The objectives of this study were to investigate the effects of feeding barley naturally contaminated with Fusarium mycotoxins on growth performance, vulva swelling, and digestibility of dry matter, organic matter, and crude protein of gilts and the recovery of gilts fed normal diets immediately after the exposure to contaminated diets by measuring growth performance and vulva swelling. In Exp. 1, four diets were prepared to contain 0%, 15%, 30%, or 45% contaminated barley containing 25.7 mg/kg deoxynivalenol and 26.0 ?g/kg zearalenone. Sixteen gilts with an initial body weight (BW) of 33.3 kg (standard deviation = 3.0) were individually housed in a metabolism crate and assigned to 4 diets with 4 replicates in a randomized complete block design based on BW. During the 14-d feeding trial, individual BW and feed consumption were measured weekly and the vertical and horizontal lengths of vulva were measured every 3 d. From d 10, feces were collected by the maker-to-marker method for 4 d. Blood samples were collected on d 14. During the overall period, the average daily gain, average daily feed intake, and gain:feed of pigs linearly decreased (p<0.01) as the dietary concentration of contaminated barley increased. However, the digestibility of crude protein was linearly increased (p = 0.011) with the increasing amounts of contaminated barley. Increasing dietary Fusarium mycotoxin concentrations did not influence vulva size, blood characteristic as well as immunoglobulin level of pigs. In the Exp. 2, a corn-soybean meal-based diet was formulated as a recovery diet. Pigs were fed the recovery diet immediately after completion of the Exp. 1. During the 14-d of recovery period, the individual BW and feed consumption were measured weekly and the vertical and horizontal length of vulva were measured every 3 d from d 0. On d 7, the feed intake of pigs previously fed contaminated diets already reached that of pigs fed a diet with 0% contaminated barley and no significant difference in growth performance among treatments was observed during d 7 to 14 of the recovery period. In conclusion, increasing levels of mycotoxins in diets linearly decreased the growth performance of pigs, and these damages can be recovered in 7 d after the diet was replaced with a normal diet. The vulva size, blood characteristic, immune responses were not affected by increasing level of contaminated barley in the diets fed to pigs. PMID:25715687

  9. Mistaken diagnosis of psychogenic gait disorder in a man with status cataplecticus ("limp man syndrome").

    PubMed

    Simon, David K; Nishino, Seiji; Scammell, Thomas E

    2004-07-01

    We report on a 45-year-old man with a history of multiple psychiatric admissions for a gait disorder and episodic weakness thought to be psychogenic who was subsequently diagnosed with status cataplecticus due to narcolepsy. The gait difficulties resolved with venlafaxine. This case demonstrates that status cataplecticus can be misdiagnosed as a psychogenic gait disorder. PMID:15254948

  10. Assessment and Treatment of Obsessive-Compulsive Disorder in College Age Students and Adults.

    ERIC Educational Resources Information Center

    Spengler, Paul M.; Jacobi, David M.

    1998-01-01

    The potential for clinical-judgment errors in assessing obsessive-compulsive disorder (OCD) makes this a good example for illustrating methods of debiasing and hypothesis testing. This article provides information about this frequently misdiagnosed disorder, delineates methods for assessment and treatment of OCD, and discusses implications of…

  11. Borrelia crocidurae meningoencephalitis, West Africa.

    PubMed

    Goutier, Sandrine; Ferquel, Elisabeth; Pinel, Claudine; Bosseray, Annick; Hoen, Bruno; Couetdic, Gérard; Bourahoui, Amina; Lapostolle, Claire; Pelloux, Hervé; Garnier, Martine; Sertour, Natacha; Pelloux, Isabelle; Pavese, Patricia; Cornet, Muriel

    2013-02-01

    Borrelia crocidurae-associated relapsing fever is endemic to West Africa and is considered benign. We report 4 patients with B. crocidurae-associated neurologic symptoms; 2 of their cases had been misdiagnosed. Frequency and severity of this disease could be underestimated; molecular methods and serodiagnostic tests for Lyme disease might be helpful in its detection. PMID:23347436

  12. Amatoxin-containing mushroom (Lepiota brunneoincarnata) familial poisoning.

    PubMed

    Varvenne, David; Retornaz, Karine; Metge, Prune; De Haro, Luc; Minodier, Philippe

    2015-04-01

    Serious to fatal toxicity may occur with amanitin-containing mushrooms ingestions. A Lepiota brunneoincarnata familial poisoning with hepatic toxicity is reported. In such poisonings, acute gastroenteritis may be firstly misdiagnosed leading to delay in preventing liver dysfunction by silibinin or penicillin G. Mushroom picking finally requires experience and caution. PMID:25831030

  13. Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

    PubMed Central

    LI, FENGSHENG; ZHANG, JIANLEI; WANG, YUNMEI; LIU, LIWEN

    2015-01-01

    The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (P<0.05). The use of CEUS demonstrates no evident advantage in the diagnosis of TMC; however, an elasticity score of ?3 is of high clinical value as a diagnostic criterion for TMC. PMID:26622676

  14. Infective endocarditis due to brucella.

    PubMed

    Purwar, S; Metgud, S C; Darshan, A; Mutnal, M B; Nagmoti, M B

    2006-10-01

    One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations. PMID:17185849

  15. Anxiety in Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    MacNeil, Bonnie M.; Lopes, Vicki A.; Minnes, Patricia M.

    2009-01-01

    Anxiety symptoms and disorders are highly prevalent in children and adolescents with Autism Spectrum Disorder (ASD), although they are often unrecognized or misdiagnosed. The purpose of the present review is to (1) provide clinicians with practical information on assessment and diagnosis of co-morbid anxiety in children and adolescents with ASD,…

  16. Identifying Hearing Loss in Young Children: Technology Replaces the Bell

    ERIC Educational Resources Information Center

    Eiserman, William; Shisler, Lenore

    2010-01-01

    Hearing loss can too easily be misdiagnosed or overlooked by providers serving young children. Parents and professionals may observe a language delay--an "invisible" condition--while failing to identify the underlying cause. Otoacoustic emissions (OAE) hearing screening technology, used extensively with newborns, is becoming an essential tool,…

  17. Foundation Phase Educators' Perceptions of Attention Deficit Hyperactivity Disorder at a Mainstream Primary School

    ERIC Educational Resources Information Center

    Seabi, J.

    2010-01-01

    Although Attention Deficit Hyperactivity Disorder (ADHD) is one of the most diagnosed conditions in children, it is also one of the misunderstood and misdiagnosed syndromes. The aim of this study was to investigate the perceptions of foundation phase educators about ADHD, specifically their views on its causes, appropriate interventions and…

  18. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    ERIC Educational Resources Information Center

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health…

  19. Suggested Readings for Cognitive Disorders Trainees Page 1 of 3 Center for Alzheimer's Care, Imaging and Research (CACIR)

    E-print Network

    Tipple, Brett

    Suggested Readings for Cognitive Disorders Trainees Page 1 of 3 Center for Alzheimer's Care, Cohen ML. Treatable neurological disorders misdiagnosed as Creutzfeldt-Jakob disease. Ann Neurol. 2011 Neurol. 2001;14(4):188-98. #12;Suggested Readings for Cognitive Disorders Trainees Page 2 of 3 Foster NL

  20. Hyperkeratotic Acral Melanoma Mimicking a Common Wart

    PubMed Central

    Vindigni, Vincenzo; Bassetto, Franco

    2015-01-01

    Summary: Acral melanoma is a great pretender; anything but i nfrequently, it adopts clinical faces, simulating skin conditions that make the healthcare provider diagnose it as a benign disease of the palms, soles, and ungual regions. We present a case of a hyperkeratotic acral melanoma that has been misdiagnosed and that has led to an amputation of the thumb. PMID:25973355

  1. Pseudomembranous-like Tinea of the Scrotum Infected by Microsporum Gypseum in a Young Man

    PubMed Central

    Tan, Huan; Lan, Xue-Mei; Zhou, Cun-Jian; Yang, Xi-Chuan

    2015-01-01

    Microsporum gypseum is a geographically widespread geophilic fungus that infects animals and humans. M. gypseum infection on the scrotum is very rare and can be easily misdiagnosed because of a lack of inflammatory reaction. Here we describe a patient with pseudomembranous-like tinea of the scrotum resulting from M. gypseum. PMID:26288444

  2. Rickettsia and Bartonella species in fleas from Reunion Island.

    PubMed

    Dieme, Constentin; Parola, Philippe; Guernier, Vanina; Lagadec, Erwan; Le Minter, Gildas; Balleydier, Elsa; Pagès, Frederic; Dellagi, Koussay; Tortosa, Pablo; Raoult, Didier; Socolovschi, Cristina

    2015-03-01

    Rickettsia felis, Rickettsia typhi, and Bartonella DNA was detected by molecular tools in 12% of Rattus rattus fleas (Xenopsylla species) collected from Reunion Island. One-third of the infested commensal rodents captured during 1 year carried at least one infected flea. As clinical signs of these zoonoses are non-specific, they are often misdiagnosed. PMID:25646263

  3. Male Anorexia Nervosa: A New Focus.

    ERIC Educational Resources Information Center

    Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

    2000-01-01

    Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better…

  4. Pars Plana Vitrectomy and Evisceration Resulting in Death Due to Misdiagnosis of Retinoblastoma in Children

    PubMed Central

    Shen, Tao; Liu, Rongjiao; Lin, Jing; Huang, Huiqun; Li, Xiuling; Yan, Jianhua

    2015-01-01

    Retinoblastoma is a curable intraocular malignancy in children. However, in clinical practice, retinoblastoma can sometimes be misdiagnosed and mismanaged, leading to extraocular extension and even death. In this report, a series of 3 cases are related that emphasize the conditions and consequences resulting from misdiagnosis and mismanagement of retinoblastoma. The clinical features, imaging findings, histopatholigical examination, and management in 3 case reports of children with misdiagnosed retinoblastoma are presented. Two of the cases received pars plana vitrectomy after being misdiagnosed with Coats disease or ocular blunt trauma, whereas the third case received evisceration after being misdiagnosed with suppurative endophthalmitis. When the diagnosis of retinoblastoma had been confirmed after a second surgery was performed in our hospital, only 2 of the cases received adjuvant orbital radiotherapy. All 3 cases died of systemic tumor metastases. Intraocular surgical procedures should be avoided in any equivocal case until the possibility of latent retinoblastoma is eliminated. We strongly recommend that early enucleation be executed as soon as possible followed by postoperative adjuvant therapy under conditions wherein an intraocular surgery was inadvertently performed in an eye with retinoblastoma. PMID:26266382

  5. Childhood Vestibular Disorders: A Tutorial

    ERIC Educational Resources Information Center

    Mehta, Zarin; Stakiw, Daria B.

    2004-01-01

    There is a growing body of evidence that childhood disorders affecting the vestibular system, although rare, do exist. Describing symptoms associated with the vestibular mechanism for children may be difficult, resulting in misdiagnosing or under-diagnosing these conditions. The pathophysiology, symptoms, and management options of the more common…

  6. Hyperekplexia in Kurdish families: a possible GLRA1 founder mutation.

    PubMed

    Sirén, A; Legros, B; Chahine, L; Misson, J-P; Pandolfo, M

    2006-07-11

    Autosomal recessive hyperekplexia is due to loss-of-function mutations in the GLRA1 gene. The authors describe six patients from two consanguineous families with a homozygous deletion of the first seven GLRA1 exons and provide evidence of a founder effect in Kurds from Turkey. Hyperekplexia may be misdiagnosed as epilepsy. PMID:16832093

  7. Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

    ERIC Educational Resources Information Center

    Cochran, Brent

    Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

  8. Imaging characteristics of disseminated Geosmithia argillacea causing severe diskospondylitis and meningoencephalomyelitis in a dog

    PubMed Central

    Kawalilak, Lukas T; Chen, Annie V; Roberts, Greg R

    2015-01-01

    Key Clinical Message A 4-year-old male castrated Labrador Retriever presented for severe spinal pain. Radiographs and magnetic resonance imaging showed evidence of diskospondylitis and meningoencephalomyelitis. Blood culture revealed a Geosmithia argillacea fungal infection after DNA sequencing, initially misdiagnosed as Penicillium species. Geosmithia argillacea should be considered as a differential for disseminated fungal diskospondylitis. PMID:26576269

  9. CARBON MONOXIDE POISONING--A PUBLIC HEALTH PERSPECTIVE.

    EPA Science Inventory

    Carbon monoxide (CO) may be the cause of more than one-half of the fatal poisonings reported in many countries: fatal cases also are grossly under-reported or mis-diagnosed by medical professionals. Therefore, the precise number of individuals who have suffered from CO intoxicat...

  10. A case of adolescent giant parathyroid adenoma presenting multiple osteolytic fractures and postoperative hungry bone syndrome

    PubMed Central

    Ebina, Kosuke; Miyoshi, Yuji; Izumi, Shinji; Hashimoto, Jun; Naka, Norifumi; Tsukamoto, Yasunori; Kashii, Masafumi; Kaito, Takashi; Yoshikawa, Hideki

    2015-01-01

    Key Clinical Message Primary hyperparathyroidism (PHPT) and postoperative hungry bone syndrome are very rare conditions in adolescents, and may be frequently misdiagnosed as a metastatic bone tumor. However, delay in diagnosis may lead to a fatal preoperative hypercalcemia and postoperative hypocalcemia. PHPT is a differential diagnosis of adolescent hypercalcemia and osteolytic fractures. PMID:26509019

  11. Zika virus infection acquired during brief travel to Indonesia.

    PubMed

    Kwong, Jason C; Druce, Julian D; Leder, Karin

    2013-09-01

    Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

  12. Zika Virus Infection Acquired During Brief Travel to Indonesia

    PubMed Central

    Kwong, Jason C.; Druce, Julian D.; Leder, Karin

    2013-01-01

    Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

  13. Full Body Gait Analysis May Improve Diagnostic Discrimination Between Hereditary Spastic Paraplegia and Spastic Diplegia: A Preliminary Study

    ERIC Educational Resources Information Center

    Bonnefoy-Mazure, A.; Turcot, K.; Kaelin, A.; De Coulon, G.; Armand, S.

    2013-01-01

    Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body…

  14. Chlorine Dioxide Induced Multiple Chemical Sensitivity: MMPI Validity Problems.

    ERIC Educational Resources Information Center

    Tentoni, Stuart C.

    This paper discusses Minnesota Multiphasic Personality Inventory (MMPI) data obtained from individuals exposed to chlorine dioxide in the workplace who developed Multiple Chemical Sensitivity Syndrome. The paper explores current research on chlorine dioxide exposed persons who were misdiagnosed on the basis of MMPI interpretations. Difficulties…

  15. Advanced Clinical Interpretation of the WAIS-IV and WMS-IV: Prevalence of Low Scores Varies by Level of Intelligence and Years of Education

    ERIC Educational Resources Information Center

    Brooks, Brian L.; Holdnack, James A.; Iverson, Grant L.

    2011-01-01

    Clinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Memory Scale-Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients…

  16. Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.

    ERIC Educational Resources Information Center

    Budd, Linda S.

    Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize…

  17. Pseudomembranous-like Tinea of the Scrotum Infected by Microsporum Gypseum in a Young Man.

    PubMed

    Tan, Huan; Lan, Xue-Mei; Zhou, Cun-Jian; Yang, Xi-Chuan

    2015-01-01

    Microsporum gypseum is a geographically widespread geophilic fungus that infects animals and humans. M. gypseum infection on the scrotum is very rare and can be easily misdiagnosed because of a lack of inflammatory reaction. Here we describe a patient with pseudomembranous-like tinea of the scrotum resulting from M. gypseum. PMID:26288444

  18. Development of an Online Resource to Support General Education Elementary School Teachers in a Response to Intervention Model for Struggling Readers

    ERIC Educational Resources Information Center

    Lopez, Jennifer L.

    2010-01-01

    The number of students who are being identified as having a learning disability is rising at an alarming rate, creating concerns regarding misdiagnoses and overrepresentation of minority groups in special education. Response to Intervention (RtI) has emerged as a scientifically validated approach to delivering quality interventions early in a…

  19. Sentence Repetition as a Measure of Morphosyntax in Monolingual and Bilingual Children

    ERIC Educational Resources Information Center

    Komeili, Mariam; Marshall, Chloe R.

    2013-01-01

    Bilingual children are frequently misdiagnosed as having Specific Language Impairment (SLI). Misdiagnosis may be minimized by tests with high degrees of sensitivity and specificity. The current study used a new test, the School-Age Sentence Imitation Test-English 32 (SASIT-E32), to investigate sentence repetition in monolingual and bilingual…

  20. Optimal Outcome in Individuals with a History of Autism

    ERIC Educational Resources Information Center

    Fein, Deborah; Barton, Marianne; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Orinstein, Alyssa; Rosenthal, Michael; Troyb, Eva; Tyson, Katherine

    2013-01-01

    Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a…

  1. An unusual case of congenital short trachea with very long bronchi mimicking bronchial asthma.

    PubMed

    Ravenna, F; Caramori, G; Panella, G L; Papi, A; Benea, G; Adcock, I M; Barnes, P J; Ciaccia, A

    2002-04-01

    Case reports of a short trachea with early branching of the main bronchi are uncommon. The case is presented of a 64 year old woman with upper airway obstruction due to this anatomical abnormality which caused breathlessness and wheezing that was misdiagnosed (and treated) as bronchial asthma for many years. PMID:11923561

  2. A plastic whistle incarcerated in bronchus diagnosed fourteen years after 'swallowed': a case report.

    PubMed

    Wang, Xin; Che, Guowei

    2014-06-01

    Tracheobronchial foreign body aspiration (FBA) is a common disease in pre-school children but easily overlooked by physicians. In this article, we report a case with bronchial stenosis that is not typical and misdiagnosed for 14 years, in the end bronchoscopy retrieval was successfully performed after adequate preparation. Pitfalls and recommendations in diagnosis and management of FBA are briefly included. PMID:24977017

  3. Transient synovitis of the hip as a complication of chickenpox in infant: Case study

    PubMed Central

    Alomar, Muaed Jamal

    2012-01-01

    Chickenpox has many rare complications; transient synovitis is one of the very painful and self-limiting rare complications. This patient suffered from transient synovitis associated with chickenpox. After being diagnosed, it was managed by diclofenac sodium suppositories. Physicians must be able to correlate all of the possible complications of chickenpox in order to avoid misdiagnoses. PMID:23960801

  4. Neosporosis in animals-the last five years

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 in dogs and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of cattle and dogs worldwide. ...

  5. [Kikuchi-Fujimoto's syndrome in ENT: a case report].

    PubMed

    Fernández Pérez, A; Fernández Nogueras Jiménez, F; Moreno León, J A; Rubí Uría, J; Fernández Sánchez, A; Bolívar Núñez, J C

    1995-01-01

    Kikuchi-Fujimoto disease (KFD) is a rare entity of uncertain cause which commonly presents as a lymphoadenopathy unresponsive to antibiotic therapy. Although usually it follows a benign self-limited course KFD has been repeatedly misdiagnosed as lymphoma. With this new case data about the etiology and clinical trend of KFD are added. Review of the literature. PMID:7710013

  6. Lyme Disease: Implications for Health Educators.

    ERIC Educational Resources Information Center

    Harbit, Maryanne Drake; Willis, Dawn

    1990-01-01

    Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

  7. Neosporosis in dogs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of dogs and cattle worldwide. Additiona...

  8. Hypothesis-Driven Story Building: Counteracting Human Cognitive Biases to Improve Medical Diagnosis Support

    ERIC Educational Resources Information Center

    Zhu, Shizhuo

    2010-01-01

    Clinical decision-making is challenging mainly because of two factors: (1) patient conditions are often complicated with partial and changing information; (2) people have cognitive biases in their decision-making and information-seeking. Consequentially, misdiagnoses and ineffective use of resources may happen. To better support clinical…

  9. A young man with altered mental status and new-onset seizures.

    PubMed

    Cassa, Richard S; Rosengart, Axel J

    2013-10-01

    Signs and symptoms of a subacute, progressive, imaging-negative encephalopathy can be misdiagnosed as a neuropsychiatric or progressive neurodegenerative disorder. However, encephalopathies often can be reversed if the autoimmune component is recognized early through a careful history and diagnostic testing, including cerebrospinal fluid analysis for antibodies. PMID:24201920

  10. Revision of the family Acidopsidae Štev?i?, 2005, and the systematic position of Typhlocarcinodes Alcock, 1900, Caecopilumnus Borradaile, 1902, and Raoulia Ng, 1987, with descriptions of two new genera and five new species (Crustacea: Brachyura: Goneplacoidea).

    PubMed

    Ng, Peter K L; Rahayu, Dwi Listyo

    2014-01-01

    The family Acidopsidae Štev?i?, 2005, is revised; and two subfamilies are recognised. The Acidopsinae Štev?i?, 2005, is characterised by the coxal male opening, a quadrate basal antennal article and vulvae arranged near the median longitudinal thoracic sternal groove. Three genera are included in the Acidopsinae: Acidops Stimpson, 1871 (with two species), Parapilumnus Kossmann, 1877 (with two species) and Crinitocinus gen. nov. (monotypic for Pilumnus alcocki Borradaile, 1902). The Raouliinae Štev?i?, 2005 (= Typhlocarcinodidae Štev?i?, 2005; Caecopilumnidae Štev?i?, 2011), is characterised by its coxo-sternal male opening, a short basal antennal article which is distinctly wider than long and vulvae arranged submedially on thoracic sternite 6. Four genera are included in the Raouliinae: Raoulia Ng, 1987 (with five species, three of which are described as new), Caecopilumnus Borradaile, 1902 (with three species of which one is described as new), Typhlocarcinodes Alcock, 1900 (monotypic) and Thecaplax gen. nov. (for one new species).  PMID:24871283

  11. Polarization dependant in vivo second harmonic generation imaging of Caenorhabditis elegans vulval, pharynx, and body wall muscles

    NASA Astrophysics Data System (ADS)

    Psilodimitrakopoulos, Sotiris; Santos, Susana; Amat-Roldan, Ivan; Mathew, Manoj; Thayil K. N., Anisha; Artigas, David; Loza-Alvarez, Pablo

    2008-02-01

    Second harmonic generation (SHG) imaging has emerged in recent years as an important laboratory imaging technique since it can provide unique structural information with submicron resolution. It enjoys the benefits of non-invasive interaction establishing this imaging modality as ideal for in vivo investigation of tissue architectures. In this study we present, polarization dependant high resolution SHG images of Caenorhabditis elegans muscles in vivo. We imaged a variety of muscular structures such as body walls, pharynx and vulva. By fitting the experimental data into a cylindrical symmetry spatial model we mapped the corresponding signal distribution of the ? (2) tensor and identified its main axis orientation for different sarcomeres of the earth worm. The cylindrical symmetry was considered to arise from the thick filaments architecture of the inside active volume. Moreover, our theoretical analysis allowed calculating the mean orientation of harmonophores (myosin helical pitch). Ultimately, we recorded and analysed vulvae muscle dynamics, where SHG signal decreased during in vivo contraction.

  12. [Surprise in abrasion diagnostics].

    PubMed

    Kellner, U; Kellner, A; Cirkel, U

    2015-05-01

    Typical localizations of gynecological squamous cell carcinomas are the cervix, vulva and vagina and are therefore not uncommonly diagnosed in curettages. A differentiation from reactive hyperplastic alterations with a possible invasiveness in samples taken from the surface of the special type of well-differentiated verrucous squamous cell carcinoma can be difficult. This pitfall of such a tumor is presented in the case described here with corresponding diagnostic difficulties. PMID:25941098

  13. The effects of hand-rearing fallow deer in a captive environment 

    E-print Network

    Healy, Allison Anne

    2013-02-22

    The fawn's only defense: lying still. 10 Nursing in the upright position. 10 Large shelter. 12 10 Introduction of the finger to initiate a suckling response. , Simulation of doe's ano-genital licking to stimulate 12 12 urination and defecation... to fourteen hours and average gestation length of 234 days (Willard, 1996). Does nearing parturition exhibit a distended abdomen, reddened vulva, and eniarged teats (Figure 3). Parturition and Cleaning. Between September 25, 1998, and November 2, 1998, ten...

  14. Total Acquired Vulval Synechia: An Unusual Presentation

    PubMed Central

    2015-01-01

    An unusual case of Acquired Total vulval synechia due to vulvar Lichen planus is reported in an 18-year-old girl, which is an extremely rare condition. It has a potential for producing extensive scarring and narrowing of introitus resulting in dyspareunia and rarely carcinoma of vulva. Successful surgical management of total vulvar synechiae in patient suffering from Lichen Planus is being reported. PMID:26023590

  15. Successful treatment of genital Bowen's disease with imiquimod 5% cream.

    PubMed

    Kishi, Chikako; Shimizu, Akira; Kato, Madoka; Amano, Hiroo; Ishikawa, Osamu

    2015-09-01

    A 64-year-old Japanese woman was diagnosed as having Bowen's disease on the vulva. The histopathological findings revealed papillomatosis, koilocytosis and clumping cells with atypical nuclei. Human papillomavirus DNA was not detected on polymerase chain reaction using consensus primers. The lesion was successfully treated with topical imiquimod 5% cream after two months. Histopathologically, no atypical cells were observed after treatment. Imiquimod can be a potential treatment modality for lesions that are difficult to treat with surgical excision. PMID:25258393

  16. Control of vulval competence and centering in the nematode Oscheius sp. 1 CEW1.

    PubMed Central

    Louvet-Vallée, Sophie; Kolotuev, Irina; Podbilewicz, Benjamin; Félix, Marie-Anne

    2003-01-01

    To compare vulva development mechanisms in the nematode Oscheius sp. 1 to those known in Caenorhabditis elegans, we performed a genetic screen for vulva mutants in Oscheius sp. 1 CEW1. Here we present one large category of mutations that we call cov, which affect the specification of the Pn.p ventral epidermal cells along the antero-posterior axis. The Pn.p cells are numbered from 1 to 12 from anterior to posterior. In wild-type Oscheius sp. 1 CEW1, the P(4-8).p cells are competent to form the vulva and the progeny of P(5-7).p actually form the vulva, with the descendants of P6.p adopting a central vulval fate. Among the 17 mutations (defining 13 genes) that we characterize here, group 1 mutations completely or partially abolish P(4-8).p competence, and this correlates with early fusion of the Pn.p cells to the epidermal syncytium. In this group, we found a putative null mutation in the lin-39 HOM-C homolog, the associated phenotype of which could be weakly mimicked by injection of a morpholino against Osp1-lin-39 in the mother's germ line. Using cell ablation in a partially penetrant competence mutant, we show that vulval competence is partially controlled by a gonadal signal. Most other mutants found in the screen display phenotypes unknown in C. elegans. Group 2 mutants show a partial penetrance of Pn.p competence loss and an abnormal centering of the vulva on P5.p, suggesting that these two processes are coregulated by the same pathway in Oscheius sp. 1. Group 3 mutants display an enlarged competence group that includes P3.p, thus demonstrating the existence of a specific mechanism inhibiting P3.p competence. Group 4 mutants display an abnormal centering of the vulval pattern on P7.p and suggest that a specific mechanism centers the vulval pattern on a single Pn.p cell. PMID:12586702

  17. Identification and characterization of a cathepsin L-like cysteine protease from Taenia solium metacestode.

    PubMed

    Li, Ai Hua; Moon, Sung-Ung; Park, Yun-Kyu; Na, Byoung-Kuk; Hwang, Myung-Gi; Oh, Chang-Mi; Cho, Shin-Hyeong; Kong, Yoon; Kim, Tong-Soo; Chung, Pyung-Rim

    2006-11-01

    Taenia solium metacestode, a larval pork tapeworm, is a causative agent of neurocysticercosis, one of the most common parasitic diseases in the human central nervous system. In this study, we identified a cDNA encoding for a cathepsin L-like cysteine protease from the T. solium metacestode (TsCL-1) and characterized the biochemical properties of the recombinant enzyme. The cloned cDNA of 1216 bp encoded 339 amino acids with an approximate molecular weight of 37.6 kDa which containing a typical signal peptide sequence (17 amino acids), a pro-domain (106 amino acids), and a mature domain (216 amino acids). Sequence alignments of TsCL-1 showed low sequence similarity of 27.3-44.6 to cathepsin L-like cysteine proteases from other helminth parasites, but the similarity was increased to 35.9-55.0 when compared to mature domains. The bacterially expressed recombinant protein (rTsCL-1) did not show enzyme activity; however, the rTsCL-1 expressed in Pichia pastoris showed typical biochemical characteristics of cysteine proteases. It degraded human immunoglobulin G (IgG) and bovine serum albumin (BSA), but not collagen. Western blot analysis of the rTsCL-1 showed antigenicity against the sera from patients with cysticercosis, sparganosis or fascioliasis, but weak or no antigenicity against the sera from patients with paragonimiasis or clonorchiasis. PMID:16872751

  18. Levels of sparganum infections and phylogenetic analysis of the tapeworm Spirometra erinaceieuropaei sparganum in wild frogs from Henan Province in central China.

    PubMed

    Wei, T; Zhang, X; Cui, J; Liu, L N; Jiang, P; Wang, Z Q

    2015-07-01

    Sparganosis is a serious food-borne parasitic zoonosis caused by infection with Spirometra spargana. The prevalence of sparganum infection in wild frogs (Rana nigromaculata, R. limmochari, R. temporaria and Bufo gargarizans) was investigated in Henan Province of central China during 2008-2012. Of 3482 caught wild frogs, 565 (16.23%) were found to be infected with plerocercoids (spargana) of the genus Spirometra. Spargana were found in 14.85% (320/2155) of R. nigromaculata, 20.82% (233/1119) of R. limmochari and 10.91% (12/110) of R. temporaria frogs. However, no sparganum was found in B. gargarizans. To investigate the phylogenetic position of collected spargana, three mitochondrial DNA (mtDNA) regions, namely cytochrome c oxidase subunits 1 and 3 (cox1 and cox3), and NADH dehydrogenase subunit 4 (nad4), were amplified, sequenced and analysed. Sequences of cox1, cox3 and pnad4 were 417, 390 and 578 bp in length, respectively. The base composition of cox1, cox3 and pnad4 were generally AT rich with a mean of 63.5%, 68.3% and 67% AT, respectively. Phylogenetic analysis showed that all the sparganum isolates in Henan Province represented Spirometra erinaceieuropaei and were a well-supported clade. These findings demonstrated clearly the usefulness of the three mtDNA sequences for molecular identification and population genetics studies of S. erinaceieuropaei spargana of human and animal health significance. PMID:26017331

  19. Zoonotic helminths affecting the human eye

    PubMed Central

    2011-01-01

    Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE) may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis), food consumption (sparganosis, trichinellosis) and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis). Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs) or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber) causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears PMID:21429191

  20. Mitochondrial Genome Sequences of Spirometra erinaceieuropaei and S. decipiens (Cestoidea: Diphyllobothriidae)

    PubMed Central

    Eom, Keeseon S.; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Jeon, Hyeong-Kyu

    2015-01-01

    The present study was performed to compare the mitochondrial genomes between 2 Spirometra tapeworms, Spirometra erinaceieuropaei and Spirometra decipiens (Cestoidea: Diphyllobothriidae), which larval stages are important etiological agents of sparganosis in humans. For each species, the full mitochondrial genome was amplified in 8 overlapping fragments using total genomic DNA purified from a single worm as the template. The mitochondrial genomes were 13,643 bp (S. erinaceieuropaei) and 13,641 bp (S. decipiens) in length and contained 36 genes; 12 protein-coding genes, 2 ribosomal RNA (rRNA, small and large subunits), and 22 transfer RNAs (tRNAs). The 12 protein-coding genes constituted 10,083 bp (S. erinaceieuropaei) and 10,086 bp (S. decipiens) of their respective mitochondrial genomes. The tRNA genes, ranging in length from 56 to 70 bp, were identified based on putative secondary structures such as the typical cloverleaf shape. A total of 23 intergenic sequences, varying from 1 to 204 bp in size, were interspersed in S. erinaceieuropaei (total, 504 bp) and S. decipiens (total, 496 bp) mtDNA. The 12 protein-coding genes of S. erinaceieuropaei and S. decipiens differed by 12.4%, whereas the overall difference in mtDNA sequence between S. erinaceieuropaei and S. decipiens was 12.9%. Thus, from the standpoint of the mitochondrial genome, S. decipiens represents a valid species that can be distinguished from S. erinaceieuropaei. PMID:26323844

  1. Infections Associated with Exotic Cuisine: The Dangers of Delicacies.

    PubMed

    Hochberg, Natasha S; Bhadelia, Nahid

    2015-10-01

    "Exotic" food dishes are an expression of regional culture, religion, and ethnicity worldwide. With the increase in international travel to remote areas of the world, globalization of the food supply, and changes in food habits, more people are consuming dishes once considered exotic. Such behavioral changes require awareness by consumers and clinicians about the risks of food-borne infections. This chapter addresses pathogens associated with consumption of raw or undercooked seafood including anisakidosis, Diphyllobothrium latum infection, flukes, and other infectious and toxin-mediated diseases. We discuss the geographic distribution of the pathogens, symptomatology, and basic principles of treatment. Food products derived from turtles, snakes, and other reptiles are reviewed, and we address the risk of gnathostomiasis, sparganosis, trichinellosis, and other pathogens. In discussing infections associated with undercooked beef, pork, and bush meat, we address dysentery, amebiasis, toxoplasmosis, Taenia infections, and risks of novel viral infections, among others. We also review infectious risks from poultry, dairy, and other food items, focusing on those organisms encountered less frequently by clinicians in developed countries. The wide range of infectious organisms related to exotic cuisine underscores the importance of educating the adventurous traveler and warrants continued vigilance on the part of the clinician. PMID:26542047

  2. Dermoscopy findings of hidroacanthoma simplex.

    PubMed

    Sato, Yota; Fujimura, Taku; Tamabuchi, Erika; Haga, Takahiro; Aiba, Setsuya

    2014-05-01

    Hidroacanthoma simplex (HAS), also known as intraepidermal eccrine poroma, is a rare eccrine adnexal tumor that tends to be misdiagnosed as other types of benign skin tumor, including clonal seborrheic keratosis. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the later development of porocarcinoma. Therefore, accurate diagnosis of HAS is indispensable for dermatologists to avoid the development of malignant tumors by an unsuitable treatment. In this report, we present the characteristic dermoscopy findings of HAS. Indeed, the dermoscopy findings might be related to the melanin-rich necrotic cells in the epidermis, which are quite different from dermoscopy findings of clonal seborrheic keratosis. As a previous report suggested, it is difficult for a dermatologist to differentiate HAS from clonal seborrheic keratosis by the naked eye. Our findings might be supportive for the early diagnosis of HAS. PMID:24987351

  3. Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess

    PubMed Central

    Alqahtani, Saad M.; Gdalevitch, Marie

    2014-01-01

    Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain. PMID:25580335

  4. A case of Hodgkin lymphoma in a patient with a history of bone pain and an initial diagnosis of chronic osteomyelitis.

    PubMed

    Griguolo, Gaia; Mazzucchelli, Luca; Cavalli, Franco; Ceriani, Luca; Zucca, Emanuele; Stathis, Anastasios

    2015-01-01

    Hodgkin lymphoma (HL) is an uncommon monoclonal lymphoid malignancy consisting of 2 main entities: classical HL and nodular lymphocyte predominant. Hodgkin lymphoma usually presents with peripheral lymphadenopathies, while extranodal involvement is rare. Prevalent osseous presentation is rare and still misdiagnosed, despite improvements in diagnostic techniques. Here we report the case of a 30-year-old man with multifocal HL bone involvement initially misdiagnosed as chronic recurrent osteomyelitis. This case emphasizes the difficulties in the diagnosis of HL presenting with bone pain and with radiologic skeletal findings not specific for lymphoma. These patients often have diagnostic delays and misdiagnosis. Repeated investigations and clinical suspicion of unusual presentations may be helpful in order to establish a correct diagnosis and start an effective treatment in this highly curable disease. PMID:25908041

  5. Isolated tubal torsion in the third trimester of pregnancy: A case report and review of the literature

    PubMed Central

    Sun, Yan; Liu, Ling-ling; Di, Jian-min

    2014-01-01

    Isolated torsion of a fallopian tube in the third trimester of pregnancy is an uncommon event. Its common symptoms are lower abdominal pain, vomiting, and nausea. Because these symptoms are nonspecific, isolated torsion of a fallopian tube may be misdiagnosed, delaying treatment and the opportunity to preserve the tube. This is a case report of a primipara in her third trimester, whowas misdiagnosed as having acute appendicitis and ovarian cyst torsion. The ultrasound-assisted examination was useful, but the specific diagnosis was made after laparotomy and histopathology. The patient was managed by simultaneous salpingectomy and cesarean section. This surgical intervention prevented adverse obstetric sequelae. We summarize our experience, provide our conclusions, and review 17 relevant studies from the literature to aid clinicians in understanding, diagnosing, and managing this condition in a timely fashion. PMID:25657760

  6. A Case of Cavernous Lymphangioma of the Small Bowel Mesentery.

    PubMed

    Hong, In Taik; Cha, Jae Myung; Lee, Joung Il; Joo, Kwang Ro; Baek, Il Hyun; Shin, Hyun Phil; Jeon, Jung Won; Lim, Jun Uk

    2015-09-25

    Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature. PMID:26387702

  7. Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms

    PubMed Central

    Chung, Jaehwan; Hwang, Soo-Hyun; Han, Jong-Woo

    2014-01-01

    Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis. PMID:25368774

  8. [Tick borne diseases].

    PubMed

    Holzer, B R

    2005-11-01

    It is known for many years that tick-borne diseases have worldwide a high economical impact on farming industry and veterinary medicine. But only in the last twenty years the importance of such diseases were notified in human medicine by the medical community and the public with emerging of the tick borne encephalitis virus and the description of Borrelia burgdorferi. It is often forgotten that many other infectious agents as bacteria, virus, Rickettsia or protozoa can be transmitted by ticks. Such diseases are rarely diagnosed in Europe either they are overlooked and misdiagnosed or they are connected with special professional activities. The development of new regions for tourism with different out door activities (adventure trips, trekking, hunting) leads to an exposure to different tick borne diseases, which are often misdiagnosed. PMID:16350539

  9. Mandibular Destruction Secondary to Invasion by Carcinoma Cuniculatum.

    PubMed

    Shapiro, Michael C; Wong, Brian; O'Brien, Michael J; Salama, Andrew

    2015-12-01

    Carcinoma cuniculatum is a rare form of well-differentiated squamous cell carcinoma that is often misdiagnosed. It has a propensity for local invasion and rarely metastasizes. Oral carcinoma cuniculatum is exceedingly rare, with very few reported cases in the English-language literature. Classically, its presentation mimics osteomyelitis or a dental abscess, resulting in misdiagnosis, multiple biopsy examinations, and procedures before a final diagnosis of carcinoma cuniculatum. This case report describes the case of a 71-year-old woman who was referred to the authors' clinic for evaluation of persistent pain and swelling of the mandible. Multiple biopsy examinations were negative for malignancy, and the patient was misdiagnosed with osteomyelitis and dental abscess before obtaining an accurate diagnosis of carcinoma cuniculatum. The aim of this report is to provide a thorough clinical and histopathologic report of carcinoma cuniculatum of the mandible, provide a brief review of the literature, and highlight the difficulties in arriving at this uncommon diagnosis. PMID:26072180

  10. Symphysis pubis osteomyelitis with bilateral adductor muscles abscess.

    PubMed

    Alqahtani, Saad M; Jiang, Fan; Barimani, Bardia; Gdalevitch, Marie

    2014-01-01

    Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain. PMID:25580335

  11. Lime-induced phytophotodermatitis

    PubMed Central

    Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

    2014-01-01

    This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

  12. Primary autoimmune myelofibrosis in a 36-year old patient presenting with isolated extreme anemia

    PubMed Central

    Santos, Fabio P S; Konoplev, Sergej N; Lu, Huifang; Verstovsek, Srdan

    2015-01-01

    Primary autoimmune myelofibrosis is a very rare condition characterized by peripheral blood cytopenias, bone marrow fibrosis with lymphoid aggregates, and by the finding of autoantibodies in peripheral blood, suggesting a systemic autoimmune process. Patients can be frequently misdiagnosed as having the more common disorder primary myelofibrosis, a myeloproliferative neoplasm. We report the case of a patient with primary autoimmune myelofibrosis with emphasis on the clinical and pathological features that lead to the diagnosis. PMID:19748119

  13. Oesophageal duplication cyst mimicking hydatid cyst in endemic areas

    PubMed Central

    Akin, Melih; Yildiz, Abdullah; Karadag, Cetin Ali; Sever, Nihat; Dokucu, Ali Ihsan

    2015-01-01

    The cystic appearance of both oesophageal duplications and pulmonary hydatid cysts can cause a misdiagnosis very easily due to rarity of cystic oesophageal duplications beside the higher incidence of hydatid cyst, especially in endemic areas. Here we report a 7-year-old girl with an oesophageal duplication cyst on the left side misdiagnosed as a hydatid cyst. The aim of the study is to report rare oesophageal duplications in the differential diagnosis of intrathoracic cysts. PMID:26702290

  14. Hair casts

    PubMed Central

    Parmar, Sweta S.; Parmar, Kirti S.; Shah, Bela J.

    2014-01-01

    Hair casts or pseudonits are circumferential concretions, which cover the hair shaft in such a way that, it could be easily removed. They are thin, cylindrical, and elongated in length. We present an unusual case of an 8-year-old girl presenting with hair casts. Occurrence of these is unusual, and they may have varied associations. This patient was suffering from developmental delay. It is commonly misdiagnosed as and very important to differentiate from pediculosis capitis. PMID:25396168

  15. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging.

    PubMed

    Kim, S W; Kim, H C; Yang, D M; Won, K Y

    2016-02-01

    Gastrointestinal stromal tumours (GISTs) can lead to emergency situations, such as gastrointestinal bleeding, intestinal obstruction, and tumoural rupture with haemoperitoneum or peritonitis. In addition, if a GIST grows exophytically to a large size, it is often misdiagnosed as a tumour arising from adjacent organs. Sometimes, the atypical appearance of GISTs on imaging causes diagnostic confusion. In this article, we illustrate a variety of GISTs with atypical presentations and also discuss the important diagnostic clues for differentiating GISTs from other lesions. PMID:26646370

  16. Late Onset Traumatic Diaphragmatic Herniation Leading to Intestinal Obstruction and Pancreatitis: Two Separate Cases

    PubMed Central

    Dinc, Tolga; Kayilioglu, Selami Ilgaz; Coskun, Faruk

    2015-01-01

    Although diaphragmatic injuries caused by blunt or penetrating trauma are rare entities, they are the most commonly misdiagnosed injuries in trauma patients and occur in approximately 3–7% of all abdominal or thoracic traumas. Acute pancreatitis secondary to late presenting diaphragmatic hernia is very rare. Here we present two separate cases: one with acute bowel obstruction and the other with acute pancreatitis secondary to late onset traumatic diaphragmatic hernia (three and twenty-eight years after chest trauma, resp.). PMID:26380126

  17. Afebrile Spotted Fever Group Rickettsia Infection After a Bite from a Dermacentor variabilis Tick Infected with Rickettsia montanensis

    PubMed Central

    McQuiston, Jennifer H.; Zemtsova, Galina; Perniciaro, Jamie; Hutson, Mark; Singleton, Joseph; Nicholson, William L.; Levin, Michael L.

    2015-01-01

    Several spotted fever group rickettsiae (SFGR) previously believed to be nonpathogenic are speculated to contribute to infections commonly misdiagnosed as Rocky Mountain spotted fever (RMSF) in the United States, but confirmation is difficult in cases with mild or absent systemic symptoms. We report an afebrile rash illness occurring in a patient 4 days after being bitten by a Rickettsia montanensis-positive Dermacentor variabilis tick. The patient’s serological profile was consistent with confirmed SFGR infection. PMID:23153005

  18. Surgical management of peripheral variant of adenomatoid odontogenic tumor: A rare case report with review.

    PubMed

    Jindwani, Karuna; Paharia, Y K; Kushwah, Atul Pratap Singh

    2015-01-01

    The adenomatoid odontogenic tumour (AOT) is a relatively uncommon lesion constituting around 3% of all odontogenic tumours and often misdiagnosed as an odontogenic cyst. It manifests as a beningn growth which affects young individuals, with a female predeliction usually in the second decade of life, exhibiting more often in the anterior region of maxilla. The current article enumerates the clinical, radiographic and histopathological features of a rare case of extraosseous AOT with its therapeutic consideration. PMID:25684929

  19. Primary granulocytic sarcoma of meninges and mediastinum as diagnostic dilemma.

    PubMed

    Samanta, Dipti Rani; Mohanty, Kirti Ranjan; Roopesh, K; Senapati, Surendra Nath

    2013-06-01

    Granulocytic sarcoma is a rare hematological neoplasm which is often misdiagnosed. We report two patients of primary granulocytic sarcoma, one at meninges who was diagnosed radiologically as meningioma and on histopathology as langerhans cell histiocytosis. The second patient presented with an ulcerated chest wall swelling, who on histopathology revealed malignant round cell tumour. Both the patients subsequently proved as primary granulocytic sarcoma on immunohistochemistry. These two cases are reported here due to their rarity. PMID:24426349

  20. Type IV Sacrococcygeal Teratoma Associated with Urogenital Sinus: Difficulties in the Prenatal Differential Diagnosis

    PubMed Central

    Sahinoglu, Zeki; Resit Asoglu, Mehmet; Özcan, Nahit

    2013-01-01

    Sacrococcygeal teratoma (SCT) is being more often detected due to availability of prenatal ultrasonography. Type IV SCT could be misdiagnosed as cloacal abnormalities due to the pelvic midline cystic mass associated with renal malformations and obstructive uropathy during the pregnancy. We discuss difficulties in the prenatal differential diagnosis of SCT and urogenital sinus in a 26-year-old pregnant woman, admitted to our prenatal diagnosis centre for a detailed US for a pre-sacral mass. PMID:26023429

  1. Acute Legionella pneumophila infection masquerading as acute alcoholic hepatitis

    PubMed Central

    Hunter, Jonathan Michael; Chan, Julian; Reid, Angeline Louise; Tan, Chistopher

    2013-01-01

    A middle-aged man had deteriorated rapidly in hospital after being misdiagnosed with acute alcoholic hepatitis. Acute Legionnaires disease (Legionellosis) was subsequently diagnosed on rapid antigen urinary testing and further confirmed serologically. This led to appropriate antibiotic treatment and complete clinical resolution. Physicians caring for patients with alcohol-related liver disease should consider Legionella pneumophila in their differential diagnosis even with a paucity of respiratory symptoms. PMID:23355576

  2. [Malignant tumours of the hand].

    PubMed

    Knudsen, Britt Mejer; Rasmussen, Per Joen Svabo; Lausten, Gunnar Schwarz; Jensen, Nina Vendel; Søe, Niels Henrik

    2011-05-30

    Malignant tumours of the hand are rare and are often misdiagnosed. A painful swelling of the hand or digits are often diagnosed with an infection, benign tumours such as ganglion cysts, or arthritis. Wounds that do not heal despite adequate treatment should be biopsied to rule out malignancy. A correct diagnosis without delay is important because the life expectancy, due to a metastasis on the hand or fingers is approximately six months. PMID:21627901

  3. Dentigerous Cyst or Adenomatoid Odontogenic Tumor: Clinical Radiological and Histopathological Dilemma

    PubMed Central

    Acharya, Shivesh; Goyal, Ashima; Rattan, Vidya; Vaiphei, Kim; Kaur Bhatia, Sarabjot

    2014-01-01

    Adenomatoid odontogenic tumor (AOT) is a well-recognised slow growing benign tumor derived from complex system of dental lamina or its remnants. This lesion is categorised into three variants of which the more common variant is follicular type which is often mistaken for dentigerous cyst. We present a case of AOT in a 14-year-old male who was misdiagnosed as dentigerous cyst. Clinical radiological and therapeutic characteristics of the case are commented on in detail. PMID:25097553

  4. Soft Tissue Chondroma: A Case Report and Literature Review

    PubMed Central

    Bahnassy, Moosa; Abdul-Khalik, Hala

    2009-01-01

    Extra skeletal soft tissue chondroma is a very rare, slow progressing, benign tumor. It has a specific tendency for hands and feet. It can sometimes be misdiagnosed as a synovial cyst or a more serious condition such as synovial sarcoma. Moreover, it can exhibit worrying radiologic and histological features mimicking chondrosarcomas. This study presents a very rare case of soft tissue chondroma of the foot. PMID:22216384

  5. Dermatomyositis as an antecedent sign of lung cancer in an eldly patient: a case report

    PubMed Central

    Shen, Cheng

    2014-01-01

    Dermatomyositis (DM) is associated with an increased risk of lung cancer. Misdiagnosed the squamous carcinoma of lung with DM is illustrated by the case who was a 73-year-old male and underwent successful surgical lobectomy presented here. The lack of examination of chest computed tomography (CT) is also emphasized. DM in an adult is a rare clinical entity. To facilitate the preoperative diagnosis and avoid the misdiagnosis of this disease, more etiological factors need to be considered. PMID:24605239

  6. Gratification Disorder Mimicking Childhood Epilepsy in an 18-month-old Nigerian Girl: A Case Report and Review of the Literature

    PubMed Central

    Ibrahim, Aliyu; Raymond, Belonwu

    2013-01-01

    Gratification disorder is common in younger children, but is often unrecognized because unlike in adolescents, it does not involve manual genital manipulation and the clinical features are quite variable; therefore a thorough history, physical examination, and video recording of the events will go a long way in making the correct diagnosis, otherwise it could easily be misdiagnosed as epilepsy, nonepileptic paroxysmal movement disorder, or even gastrointestinal disorder. PMID:24379510

  7. Frequent misdiagnosis of adult polyglucosan body disease.

    PubMed

    Hellmann, Mark A; Kakhlon, Or; Landau, Ezekiel H; Sadeh, Menachem; Giladi, Nir; Schlesinger, Ilana; Kidron, Daphne; Abramsky, Oded; Reches, Avinoam; Argov, Zohar; Rabey, Jose M; Chapman, Joab; Rosenmann, Hanna; Gal, Aya; Moshe Gomori, J; Meiner, Vardiella; Lossos, Alexander

    2015-10-01

    Adult polyglucosan body disease (APBD) is a rare glycogenosis manifesting progressive spastic paraparesis, sensorimotor polyneuropathy and neurogenic bladder. Misdiagnosis of APBD may lead to unnecessary investigations and to potentially harmful therapeutic interventions. To examine the frequency of misdiagnosis of APBD, we retrospectively reviewed the clinical data of 30 patients diagnosed between 1991 and 2013. Diagnosis was based on the combination of typical clinical and imaging findings, reduced glycogen branching enzyme activity, and the presence of p.Y326S GBE1 mutation. Initial symptoms started in the 5th-6th decade with bladder dysfunction (47 %), gait problems (33 %) or both. Diagnosis of APBD was delayed by 6.8 (±4.8) years. Consistent signs at diagnosis were spasticity in the legs (93 %), decreased or absent ankle reflexes (100 %), bilateral extensor plantar response (100 %) and distal sensory deficit (80 %). Nerve conduction study showed invariable sensorimotor polyneuropathy, and MRI demonstrated cervical spinal cord atrophy (100 %) and leukoencephalopathy (97 %). All 30 patients were initially misdiagnosed. Common misdiagnoses included cerebral small vessel disease (27 %), multiple sclerosis (17 %), amyotrophic lateral sclerosis (17 %) and peripheral neuropathies (20 %). Consequently, 27 % received inappropriate therapy. In addition, lower urinary tract symptoms in 60 % of men were attributed solely to prostatic disorders but did not respond to medical treatment or prostatectomy. These findings suggest that despite limited clinical variability, APBD is invariably misdiagnosed and patients are often mistreated. Physicians' unfamiliarity with the typical clinical and imaging features of APBD appears as the main reason for misdiagnosis. PMID:26194201

  8. Is there a cartesian renaissance of the mind or is it time for a new taxonomy for low responsive states?

    PubMed

    Pistoia, Francesca; Sarà, Marco

    2012-09-01

    The mass media have recently pointed out the likelihood of diagnostic errors in post-coma patients. Late recoveries of consciousness, even after 20 years, might indicate hidden misdiagnoses that are not corrected over a long period of time. The rate of misdiagnoses of patients in a vegetative state is very high when based on behavioral assessment strategies alone. An extremely restrictive motor repertoire, as occurs in locked-in patients, seems to be the major factor responsible for diagnostic confusion. Functional neuroimaging techniques are regarded as promising tools in unearthing covert awareness in behaviorally unresponsive patients who are unable to produce any motor output. However, unless we believe that these patients persistently live in an unconvincing Cartesian-like state, in which thinking and acting are mutually dissociated, we have to admit that a new taxonomy for low responsive states is called for. This taxonomy should take into account the possible syndromic overlap between disorders of consciousness and locked-in syndrome. We should suspect a "locked-in state" in behaviorally unresponsive patients unless we reach strong evidence that such is not the case; this is the only way to avoid dramatic misdiagnoses. PMID:21488720

  9. Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.

    PubMed

    Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

    2014-11-01

    Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications. PMID:25190008

  10. Receptivity of female Neohelice granulata (Brachyura, Varunidae): different strategies to maximize their reproductive success in contrasting habitats

    NASA Astrophysics Data System (ADS)

    Sal Moyano, María Paz; Luppi, Tomás; Gavio, María Andrea; Vallina, Micaela; McLay, Colin

    2012-12-01

    The extent of the receptive period may determine the mating strategies employed by female crabs to obtain mates. Here, we studied the receptivity of female Neohelice granulata (Dana, 1851) in the laboratory, including the form of the vulvae and the anatomy of the seminal receptacle (SR). We examined the factors that influence the duration of receptivity by comparing two populations inhabiting contrasting habitats: Mar Chiquita Coastal lagoon (MCL), which is an oligo-polyhaline estuary, and San Antonio Oeste (SAO), which is an eu-hyperhaline marine bay. Non-receptive females have immobile vulva opercula, while receptive females have mobile opercula. Histological sections of the SR showed that the degree of epithelium secretions was associated with the receptive stage of females, and they may be involved in the maintenance of viable sperm and in the dehiscence of spermatophores. The existence of a special tissue at the junction of the oviduct and the SR was described and proposed as an internal mechanism influencing the timing of ovulation. The duration of receptivity was dependent on the SR load and the capacity to lay eggs. Thus, females with empty SR exhibited longer receptivity and did not lay eggs, while those with full SR exhibited shorter receptivity and always laid eggs. Interpopulation differences showed that females from SAO had shorter receptivity and heavier SR and laid eggs more frequently than females from MCL. Based on our results, we suggest that N. granulata females can adjust the duration of their receptivity and control the moment of fertilization according to different internal mechanisms related to the morphology of the vulvae, the fullness of the SR and anatomical attributes of the SR. An important consequence of this control is greater sperm competition. The extent of the receptive period and the number of times that a female could become receptive in a single reproductive season may also depend on the habitat characteristics.

  11. Reaction to biological drugs: infliximab for the treatment of toxic epidermal necrolysis subsequently triggering erosive lichen planus.

    PubMed

    Worsnop, F; Wee, J; Natkunarajah, J; Moosa, Y; Marsden, R

    2012-12-01

    Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin reaction for which there is currently has no standardized treatment, despite its significant mortality. Biological agents such as tumour necrosis factor (TNF)-? antagonists are emerging as a novel treatment for patients with TEN. We report a 32-year-old woman who developed TEN secondary to sulfasalazine, which was treated with infliximab. The infliximab treatment subsequently triggered erosive lichen planus (LP) involving the mouth and vulva. Clinicians should be aware that TNF-? antagonists can cause LP as a paradoxical complication of treatment. PMID:22548502

  12. Ganglion affection in the invasive vulvar carcinoma.

    PubMed

    López García, N; Recio Sánchez, S; Sánchez Clemente, C; García Gallego, A

    1987-01-01

    This is a study of 150 cases of epidermal carcinoma of the vulva, treated in the Service of Gynecology of the National Institute on Oncology, of which inguinal lymphoadenectomy was practised in 126 cases. The histopathological study of the ganglions removed shows an incidence of 42% of total metastasis. Ganglionic metastasis was analyzed side by side with the clinical state and that of the localization of the tumor. The results of the metastasis of the "Cloquet ganglions" are also presented plus the invasion of the regional pelvic-ganglions with the existence or non-existence in the above mentioned ganglions. PMID:3569318

  13. HPV infection, anal intra-epithelial neoplasia (AIN) and anal cancer: current issues

    E-print Network

    Stanley, Margaret A.; Winder, David M.; Sterling, Jane C.; Goon, Peter K. C.

    2012-09-08

    -genital mucosae (cervix, vagina, vulva, anus and penis) are oncogenic viruses causing ~ 5.2% of total human cancers [1]. Like cervical cancer, squamous cell carcinoma of the anus (anal SCC) is thought to be preceded by a spectrum of intra- epithelial changes, anal... , not sexual preference; increases in incidence were shown before the advent of the HIV epidemic [3]. The majority of studies of prevalence of anal HPV infection and AIN have been in the MSM cohort, especially HIV-positive MSM, as this is the highest risk group...

  14. Clinical effect of Kukkutanda Twak Bhasma in the management of Swetapradara

    PubMed Central

    Panda, Gatikrushna; Mohapatra, K. B.

    2011-01-01

    Swetapradara is an important gynecological disorder nowadays. Most women in the reproductive age group complain about white discharge. Due to white discharge, they are prone to so many other symptoms, such as backache, itching in vulva, and burning micturition. According to Ayurveda, swetapradara is caused by the vitiation of Kapha and Vata dosha. Kukkutanda twak is also said to be Kapha Vata shamaka and swetapradara shamaka. In Ayurveda so many drugs are mentioned in the treatment of swetapradara. Among them Kukkutanda twak bhasma is a good medicine. In this clinical study Kukkutanda twak bhasma has shown statistically significant improvement in white discharge, backache, itching, anemia, weakness, and urinary tract infection. PMID:22529653

  15. Hysteroscopy and episiotomy in a rescued, cold-stressed Florida manatee (Trichechus manatus latirostris) for diagnosis and treatment of a retained fetal skeleton.

    PubMed

    Hall, Natalie H; Walsh, Mike; DeLuca, Catherine; Bukoski, Alex

    2012-09-01

    A rescued female manatee was observed expelling a fetal bone from the vulva. The manatee was anesthetized and diagnosed with uterine retention of a fetal skeleton by ultrasound and hysteroscopy. Episiotomy was performed to gain manual access to the vagina and uterus for removal of the skeleton. Second intention healing of the episiotomy site produced excellent results. Rescued female manatees should receive a thorough reproductive tract evaluation since presence of retained fetal tissues might not be evident in blood or hormone analyses. Retention of a whole or partial dead fetus can be life-threatening to manatees, and retained tissues should be removed as early as possible. PMID:23082540

  16. Update in Cancer Chemotherapy: Genitourinary Tract Cancer, Part 3: Cancer of the Prostate

    PubMed Central

    Wright, Jane C.

    1988-01-01

    An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 3 is a review of treatments for cancer of the prostate. The role of cancer chemotherapeutics as adjuvant therapy and in combination modalities in the treatment of prostatic carcinoma has yet to be determined. No single agent or combination can be considered standard therapy. The role of chemotherapy in prostatic carcinoma needs further definition. Only through randomized trials will better guides to better treatment be established. PMID:3280813

  17. Catheterization of the urethra in female pigs.

    PubMed

    Musk, G C; Zwierzchoniewska, M; He, B

    2015-10-01

    Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow diverticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed. PMID:25977261

  18. The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

    PubMed Central

    Devleesschauwer, Brecht; Ale, Anita; Torgerson, Paul; Praet, Nicolas; Maertens de Noordhout, Charline; Pandey, Basu Dev; Pun, Sher Bahadur; Lake, Rob; Vercruysse, Jozef; Joshi, Durga Datt; Havelaar, Arie H.; Duchateau, Luc; Dorny, Pierre; Speybroeck, Niko

    2014-01-01

    Background Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding. Methodology We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs. Principal Findings Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450–27,694] and 9255 DALYs [95% CrI: 6135–13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105–458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur. Conclusions/Significance In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more complete picture of the impact of these diseases. PMID:24392178

  19. Genetic Structure Analysis of Spirometra erinaceieuropaei Isolates from Central and Southern China

    PubMed Central

    Zhang, Xi; Cui, Jing; Liu, Li Na; Jiang, Peng; Wang, Han; Qi, Xin; Wu, Xing Qi; Wang, Zhong Quan

    2015-01-01

    Background Sparganosis caused by invasion of the plerocercoid larvae (spargana) of Spirometra erinaceieuropaei have increased in recent years in China. However, the population genetic structure regarding this parasite is still unclear. In this study, we used the sequences of two mitochondrial genes cytochrome b (cytb) and cytochrome c oxidase subunit I (cox1) to analyze genetic variation and phylogeographic structure of the S. erinaceieuropaei populations. Methodology/Principal Findings A total of 88 S. erinaceieuropaei isolates were collected from naturally infected frogs in 14 geographical locations of China. The complete cytb and cox1 genes of each sample was amplified and sequenced. Total 61 haplotypes were found in these 88 concatenated sequences. Each sampled population and the total population have high haplotype diversity (Hd), accompanied by very low nucleotide diversity (Pi). Phylogenetic analyses of haplotypes revealed two distinct clades (HeN+HuN+GZ-AS clade and GX+HN+GZ-GY clade) corresponding two sub-networks yielded by the median-joining network. Pairwise FST values supported great genetic differentiation between S. erinaceieuropaei populations. Both negative Fu’s FS value of neutrality tests and unimodal curve of mismatch distribution analyses supported demographic population expansion in the HeN+HuN+GZ-AS clade. The BEAST analysis showed that the divergence time between the two clades took place in the early Pleistocene (1.16 Myr), and by Bayesian skyline plot (BSP) an expansion occurred after about 0.3 Myr ago. Conclusions S. erinaceieuropaei from central and southern China has significant phylogeographic structure, and climatic oscillations during glacial periods in the Quaternary may affect the demography and diversification of this species. PMID:25793277

  20. Human Infections with Spirometra decipiens Plerocercoids Identified by Morphologic and Genetic Analyses in Korea

    PubMed Central

    Jeon, Hyeong-Kyu; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Huh, Sun; Sohn, Woon-Mok; Chai, Jong-Yil; Eom, Keeseon S.

    2015-01-01

    Tapeworms of the genus Spirometra are pseudophyllidean cestodes endemic in Korea. At present, it is unclear which Spirometra species are responsible for causing human infections, and little information is available on the epidemiological profiles of Spirometra species infecting humans in Korea. Between 1979 and 2009, a total of 50 spargana from human patients and 2 adult specimens obtained from experimentally infected carnivorous animals were analyzed according to genetic and taxonomic criteria and classified as Spirometra erinaceieuropaei or Spirometra decipiens depending on the morphology. Morphologically, S. erinaceieuropaei and S. decipiens are different in that the spirally coiled uterus in S. erinaceieuropaei has 5-7 complete coils, while in S. decipiens it has only 4.5 coils. In addition, there is a 9.3% (146/1,566) sequence different between S. erinaceieuropaei and S. decipiens in the cox1 gene. Partial cox1 sequences (390 bp) from 35 Korean isolates showed 99.4% (388/390) similarity with the reference sequence of S. erinaceieuropaei from Korea (G1724; GenBank KJ599680) and an additional 15 Korean isolates revealed 99.2% (387/390) similarity with the reference sequences of S. decipiens from Korea (G1657; GenBank KJ599679). Based on morphologic and molecular databases, the estimated population ratio of S. erinaceieuropaei to S. decipiens was 35: 15. Our results indicate that both S. erinaceieuropaei and S. decipiens found in Korea infect humans, with S. erinaceieuropaei being 2 times more prevalent than S. decipiens. This study is the first to report human sparganosis caused by S. decipiens in humans in Korea. PMID:26174823

  1. Vulvar cancer: epidemiology, clinical presentation, and management options

    PubMed Central

    Alkatout, Ibrahim; Schubert, Melanie; Garbrecht, Nele; Weigel, Marion Tina; Jonat, Walter; Mundhenke, Christoph; Günther, Veronika

    2015-01-01

    Epidemiology Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. Histology Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%). Clinical features Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain. Therapy The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema. Prognosis The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival. PMID:25848321

  2. Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 2.

    PubMed

    Chokoeva, A A; Tchernev, G; Cardoso, J C; Patterson, J W; Dechev, I; Valkanov, S; Zanardelli, M; Lotti, T; Wollina, U

    2015-06-01

    Malignant tumors of the female reproductive system are a serious health and social problem, as they are the second most common cause of death among women, after breast cancer. Vulvar tumors represent only 4% of all gynecological neoplasms, and they are fourth in frequency after tumors of the cervix, uterus, and ovary. Ninety-eight percent of all vulvar tumors are benign and only 2% are malignant. Sarcomas of the vulva comprise approximately 1-3% of all vulvar cancers. They are characterized by rapid growth, high metastatic potential, frequent recurrences, aggressive behavior, and high mortality rate. In Part 1 of this paper, we presented the most common forms of sarcoma of the vulva: leiomyosarcoma, epithelioid sarcoma, malignant rhabdoid tumor, and rhabdomyosarcoma. The second part of this review will focus mainly on the rarest variants of vulvar sarcoma: low-grade fibromyxoid sarcoma, synovial sarcoma, monophasic synovial sarcoma, carcinosarcoma, Ewing sarcoma, myeloid sarcoma, dermatofibrosarcoma protuberans, malignant fibrous histiocytoma, angiomatoid fibrous histiocytoma, liposarcoma, malignant peripheral nerve sheath tumor, and malignant mesothelioma. PMID:25816393

  3. Chromatin regulation and sumoylation in the inhibition of Ras-induced vulval development in Caenorhabditis elegans

    PubMed Central

    Poulin, Gino; Dong, Yan; Fraser, Andrew G; Hopper, Neil A; Ahringer, Julie

    2005-01-01

    In Caenorhabditis elegans, numerous ‘synMuv' (synthetic multivulval) genes encode for chromatin-associated proteins involved in transcriptional repression, including an orthologue of Rb and components of the NuRD histone deacetylase complex. These genes antagonize Ras signalling to prevent erroneous adoption of vulval fate. To identify new components of this mechanism, we performed a genome-wide RNA interference (RNAi) screen. After RNAi of 16 757 genes, we found nine new synMuv genes. Based on predicted functions and genetic epistasis experiments, we propose that at least four post-translational modifications converge to inhibit Ras-stimulated vulval development: sumoylation, histone tail deacetylation, methylation, and acetylation. In addition, we demonstrate a novel role for sumoylation in inhibiting LIN-12/Notch signalling in the vulva. We further show that many of the synMuv genes are involved in gene regulation outside the vulva, negatively regulating the expression of the Delta homologue lag-2. As most of the genes identified in this screen are conserved in humans, we suggest that similar interactions may be relevant in mammals for control of Ras and Notch signalling, crosstalk between these pathways, and cell proliferation. PMID:15990876

  4. Incidence Patterns and Temporal Trends of Invasive Nonmelanotic Vulvar Tumors in Germany 1999-2011. A Population-Based Cancer Registry Analysis

    PubMed Central

    Buttmann-Schweiger, Nina; Klug, Stefanie J.; Luyten, Alexander; Holleczek, Bernd; Heitz, Florian; du Bois, Andreas; Kraywinkel, Klaus

    2015-01-01

    Objectives Time trends on the incidence and characteristics of invasive vulvar cancer in Germany have so far been studied in few local population- and hospital based tumor registries. We aimed to provide an overview on recent developments of vulvar cancer in Germany, using population-based cancer registry data. Methods We analyzed the data on vulvar cancer of eight population-based German cancer registries for the period 1999-2011. ICD-10 codes and ICD-O-3 morphology codes were used to select site and histologic types. The annual percentage change was calculated on age-adjusted incidence rates with a joinpoint regression model. Results A total of 12,711 registered cases of invasive carcinoma of the vulva were included in the analyses, hereof were 12,205 of squamous cell origin. Age-standardized incidence rates of vulvar cancer annually increased by 6.7% (95% confidence limits: 5.6-7.9) from 1.7 per 100,000 women in 1999 to 3.6 per 100,000 women in 2011. An increase was observed among women of all ages, and especially between 30 and 69 years of age. Conclusion The annual incidence of invasive carcinoma of the vulva nearly doubled in the past decade in Germany, considerably exceeding the rates observed in other Western European countries. A combination of changes in risk factors, and documentation practice might have contributed to the observed substantial increase in vulvar cancer incidence. PMID:26020540

  5. Collision of Ductal Carcinoma In Situ of Anogenital Mammary-like Glands and Vulvar Sarcomatoid Squamous Cell Carcinoma.

    PubMed

    Tran, Tien A N; Deavers, Michael T; Carlson, J Andrew; Malpica, Anais

    2015-09-01

    A spectrum of invasive adenocarcinomas presumably arising from the anogenital mammary-like glands of the vulva has been reported. Even rarer are the cases of pure ductal carcinoma in situ that originated from these unique glandular structures. Herein, we report an 81-yr-old woman presented with an invasive well-differentiated squamous cell carcinoma of the vulva. Unexpectedly, the underlying dermis demonstrated a cystically dilated structure that displayed a layer of malignant squamous cells in the periphery, and a second centrally located population of neoplastic cells exhibiting glandular differentiation. In addition, a spindle and pleomorphic malignant cell population consistent with a sarcomatoid carcinoma was identified around the cystic structure. Scattered benign anogenital mammary-like glands were present in the adjacent dermis. The histologic and immunohistochemical findings were consistent with those of vulvar squamous cell carcinoma that has undergone sarcomatoid transformation after spreading in a pagetoid fashion into an underlying focus of ductal carcinoma in situ of anogenital mammary-like gland origin. PMID:26107561

  6. Cryphodera sinensis n. sp. (Nematoda: Heteroderidae), a non-cyst-forming parasitic nematode from the root of ramie Boehmeria nivea in China.

    PubMed

    Zhuo, K; Wang, H H; Ye, W; Peng, D L; Liao, J L

    2014-12-01

    Cryphodera sinensis n. sp. is described from ramie (Boehmeria nivea) based on the morphology and molecular analyses of rRNA small subunit (SSU), D2D3 expansion domains of large subunit (LSU D2D3) and internal transcribed spacer (ITS). This new species is characterized by oval females with a distinct subcrystalline layer and pronounced and protruding vulval lip, distinctly concave vulva-anus profile and a vulva-anus distance of 29.5-35.8 ?m. Males possess two annuli in the lip region, a stylet 27-32.5 ?m in length with round knobs sloping slightly posteriorly, lateral fields with three lines, spicules 20-28 ?m long and the presence of a short cloacal tube. Second-stage juveniles possess three lip annuli, a stylet 28-31 ?m in length with well-developed knobs projected anteriorly and three lines along the lateral field. The pointed tail, 52-65 ?m long, possesses a mucro-like tip and a hyaline region, 24.5-35 ?m long. Large phasmids with a lens-like structure are located 2-6 annuli posterior to the anus. Phylogenetic analysis shows that the species has unique SSU, LSU D2D3 and ITS rRNA sequences. Phylogenetic relationships of the three rDNA sequences of C. sinensis n. sp. and other cystoid/cyst nematodes are analysed together with a comparison of other species within the genus Cryphodera. PMID:23782683

  7. A Cholinergic-Regulated Circuit Coordinates the Maintenance and Bi-Stable States of a Sensory-Motor Behavior during Caenorhabditis elegans Male Copulation

    PubMed Central

    Liu, Yishi; LeBeouf, Brigitte; Guo, Xiaoyan; Correa, Paola A.; Gualberto, Daisy G.; Lints, Robyn; Garcia, L. Rene

    2011-01-01

    Penetration of a male copulatory organ into a suitable mate is a conserved and necessary behavioral step for most terrestrial matings; however, the detailed molecular and cellular mechanisms for this distinct social interaction have not been elucidated in any animal. During mating, the Caenorhabditis elegans male cloaca is maintained over the hermaphrodite's vulva as he attempts to insert his copulatory spicules. Rhythmic spicule thrusts cease when insertion is sensed. Circuit components consisting of sensory/motor neurons and sex muscles for these steps have been previously identified, but it was unclear how their outputs are integrated to generate a coordinated behavior pattern. Here, we show that cholinergic signaling between the cloacal sensory/motor neurons and the posterior sex muscles sustains genital contact between the sexes. Simultaneously, via gap junctions, signaling from these muscles is transmitted to the spicule muscles, thus coupling repeated spicule thrusts with vulval contact. To transit from rhythmic to sustained muscle contraction during penetration, the SPC sensory-motor neurons integrate the signal of spicule's position in the vulva with inputs from the hook and cloacal sensilla. The UNC-103 K+ channel maintains a high excitability threshold in the circuit, so that sustained spicule muscle contraction is not stimulated by fewer inputs. We demonstrate that coordination of sensory inputs and motor outputs used to initiate, maintain, self-monitor, and complete an innate behavior is accomplished via the coupling of a few circuit components. PMID:21423722

  8. A novel vaccine for cervical cancer: quadrivalent human papillomavirus (types 6, 11, 16 and 18) recombinant vaccine (Gardasil).

    PubMed

    Govan, Vandana A

    2008-02-01

    Human papillomaviruses (HPVs) are one of the most common sexually transmitted infections and remains a public health problem worldwide. There is strong evidence that HPV causes cervical, vulva and vaginal cancers, genital warts and recurrent respiratory papillomatosis. The current treatments for HPV-induced infections are ineffective and recurrence is common-place. Therefore, to reduce the burden of HPV-induced infections, several studies have investigated the effi cacy of different prophylactic vaccines in clinical human trials directed against HPV types 6, 11, 16, or 18. Notably, these HPV types contribute to a signifi cant proportion of disease worldwide. This review will focus on the published results of Merck & Co's prophylactic quadrivalent recombinant vaccine targeting HPV types 6, 11, 16, and 18 (referred to as Gardasil((R))). Data from the Phase III trial demonstrated that Gardasil was 100% effi cacious in preventing precancerous lesions of the cervix, vulva, and vagina and effective against genital warts. Due to the success of these human clinical trials, the FDA approved the registration of Gardasil on the 8 June 2006. In addition, since Gardasil has been effi cacious for 5 years post vaccination, the longest evaluation of an HPV vaccine, it is expected to reduce the incidence of these type specifi c HPV-induced diseases in the future. PMID:18728721

  9. Changes in Men’s Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents

    PubMed Central

    Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E.; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

    2013-01-01

    Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75?min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

  10. [Vaginismus and our experience in treating this sexual problem].

    PubMed

    Sirakov, M

    2013-01-01

    According to various statistics from 4.2 to 42% of women in reproductive age, complained of a mild or severe problems in sexual function. The study presents own data on treatment of vaginismus in 14 girls and young women aged 16 to 36 years who have turned from 2007 to 2012 to the Cabinet Children and adolescent gynaecology at the University Hospital "Maychin dom". A primary examination established a high and tenacious hymen in 7 (50%) patients. The patients demonstrated fear, but still allowed careful examination. At 3 girls (21.43%) a combined cause of complaints was found. They demonstrated fear of pain during coitus and reported bad memory of the first sexual attempts; they had high and tenacious hymen and were able to tolerate touching the vulva after much persusions. In 3 (21.43%) patients consequences of puritan education were registered. They did not allowed to touch the vulva despite the declaration that would allow such. In one patients (7.14%) a unstretchable vagina was found. She demonstrated dyspareunia (avoiding intercourse and having one failed marriage) but she tolerated penetration of her vagina of one phalanx. In all cases of vaginismus we performed educational lectures and artefitial defloration. PMID:23805463

  11. Electrosurgical operation of vulvar carcinoma with postoperative irradiation of inguinal lymph nodes

    SciTech Connect

    Kucera, H.; Weghaupt, K.

    1988-02-01

    The results of treatment in the department of 607 patients with invasive squamous cell carcinoma of the vulva between 1952 and 1980 is described and analyzed. The absolute 5-year cure rate in these patients was 60.3%. Particular attention was given to lymph node status (TNM system) in the analysis of the last 141 patients treated. The absolute 5-year survival rate was 67% for the N0-N1 patients and 43% for the N2-N3 patients. Patients were treated uniformly by means of electrosurgical operation and postactinic irradiation of the inguinal lymph nodes. Operative lymphadenectomy was performed only in 5% of cases when the diameter of inguinal lymph nodes was greater than 2 cm. This simple surgical technique, in combination with irradiation of inguinal lymph nodes, gives excellent results and avoids the complications associated with inguinofemoral lymphadenectomy. Owing to its combination of electrosurgical operation of the vulva and irradiation of the inguinal regions as a standard procedure, the treatment involves extremely low strain on the patient and is almost free of complications. This seems to be particularly important as the results of our treatment are not less satisfactory than those of more aggressive procedures.

  12. Missed Opportunities to Diagnose Tuberculosis Are Common Among Hospitalized Patients and Patients Seen in Emergency Departments

    PubMed Central

    Miller, Aaron C.; Polgreen, Linnea A.; Cavanaugh, Joseph E.; Hornick, Douglas B.; Polgreen, Philip M.

    2015-01-01

    Background.?Delayed diagnosis of tuberculosis (TB) may lead to worse outcomes and additional TB exposures. Methods.?To estimate the potential number of misdiagnosed TB cases, we linked all hospital and emergency department (ED) visits in California?s Healthcare Cost and Utilization Project (HCUP) databases (2005–2011). We defined a potential misdiagnosis as a visit with a new, primary diagnosis of TB preceded by a recent respiratory-related hospitalization or ED visit. Next, we calculated the prevalence of potential missed TB diagnoses for different time windows. We also computed odds ratios (OR) comparing the likelihood of a previous respiratory diagnosis in patients with and without a TB diagnosis, controlling for patient and hospital characteristics. Finally, we determined the correlation between a hospital?s TB volume and the prevalence of potential TB misdiagnoses. Results.?Within 30 days before an initial TB diagnosis, 15.9% of patients (25.7% for 90 days) had a respiratory-related hospitalization or ED visit. Also, within 30 days, prior respiratory-related visits were more common in patients with TB than other patients (OR = 3.83; P < .01), controlling for patient and hospital characteristics. Respiratory diagnosis-related visits were increasingly common until approximately 90 days before the TB diagnosis. Finally, potential misdiagnoses were more common in hospitals with fewer TB cases (? = ?0.845; P < .01). Conclusions.?Missed opportunities to diagnose TB are common and correlate inversely with the number of TB cases diagnosed at a hospital. Thus, as TB becomes infrequent, delayed diagnoses may increase, initiating outbreaks in communities and hospitals. PMID:26705537

  13. A minimal form of Proteus syndrome presenting with macrodactyly and hand hyperplasia.

    PubMed

    Morelli, Federica; Feliciani, Claudio; Toto, Paola; De Benedetto, Anna; Tulli, Antonello

    2003-01-01

    Proteus syndrome is a rare congenital disorder characterized by progressive course and great variability of clinical presentation with partial gigantism of extremities, hemihyperplasia with macrocephaly, epidermal nevus, mesodermal hamartomas and the presence of peculiar cerebriform masses on the palms/soles. Many atypical cases have been reported and this is probably due to the mosaicism of the genetic disorder displaying different clinical features. We describe a patient with an extremely mild form of Proteus syndrome presenting macrodactyly and hyperplasia of one hand which was misdiagnosed until the age of 33 years. PMID:12695139

  14. Musician's dystonia.

    PubMed

    Sussman, Jon

    2015-08-01

    Musician's dystonia is a task-specific dystonia that usually affects the embouchure or the most active digits of the most active hand, and therefore differs between instruments. Since it is usually painless and intermittent, the diagnosis is often delayed and it is commonly misdiagnosed as being an overuse disorder or tendon pathology. It arises from pathological brain plasticity: physiological studies suggest that it is an exaggeration of brain changes that are required to achieve advanced musical skills. Its treatment often has limited success; however, musical retraining, botulinum toxin or rehabilitation based on modifying the aberrant plasticity may help. PMID:26023204

  15. Reducing cognitive errors in dermatology: can anything be done?

    PubMed

    Dunbar, Miles; Helms, Stephen E; Brodell, Robert T

    2013-11-01

    An increasing focus on the prevention of medical errors is a direct result of a growing patient safety movement. Although the reduction of technical errors has been the focus of most interventions, cognitive errors, usually more than one error linked together, actually cause the majority of misdiagnoses. This article examines the most common types of cognitive errors in dermatology. Two methods to minimize these errors are recommended: first, cognitive debiasing techniques reduce the common initiating factor of error cascades; and secondly, the application of prospective hindsight attacks the final common pathway that leads to misdiagnosis. PMID:24124811

  16. Elongated left lobe of the liver mimicking a subcapsular hematoma of the spleen on the focused assessment with sonography for trauma exam.

    PubMed

    Jones, Robert; Tabbut, Matthew; Gramer, Diane

    2014-07-01

    The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking contained fluid collections with hemoperitoneum. We present a case in which an elongated left lobe of the liver was misdiagnosed as a splenic subcapsular hematoma. It is imperative that emergency physicians and trauma surgeons be familiar with this normal variant of the liver and its associated sonographic appearance on the perisplenic window in order to prevent nontherapeutic laparotomies or embolizations. PMID:24556519

  17. Food Protein-Induced Enterocolitis Syndrome.

    PubMed

    Leonard, Stephanie A; Nowak-W?grzyn, Anna

    2015-12-01

    Food protein-induced enterocolitis syndrome (FPIES) is a rare, non-immunoglobulin E-mediated gastrointestinal food allergy primarily diagnosed in infancy, but has also been reported in older children and adults. Acute FPIES reactions typically present with delayed, repetitive vomiting, lethargy, and pallor within 1 to 4 hours of food ingestion. Chronic FPIES typically presents with protracted vomiting and/or diarrhea, and weight loss or poor growth. Common foods triggering FPIES include cow's milk, soy, rice, oats, fish, and egg. More detailed diagnostic criteria may help in increasing awareness of FPIES and reducing delayed diagnoses or misdiagnoses. PMID:26456444

  18. Buccal mucosal hypertrophy secondary to open bite

    PubMed Central

    Nilima, S.; Sharma, Anuj

    2015-01-01

    Timely and accurate diagnosis of a medical/dental condition is the first critical step to ensure appropriate treatment. Lack of astuteness in diagnosis may assume many forms. Each medical/dental practitioner is morally and legally bound to perform his or her duties to a specified standard of care. The cause of misdiagnosis may be hurriedness, lack of testing, or a simple mistake; failure to diagnose can constitute a breach of that duty, making the medical/dental provider liable for any resulting damages. The following case report highlights one such misdiagnosed case. PMID:26604584

  19. Omental infarction in the postpartum period: a case report and a review of the literature

    PubMed Central

    2010-01-01

    Introduction Omental infarction is a rare and often misdiagnosed clinical event with unspecific symptoms. It affects predominantly young and middle aged women. Case presentation This is a case report of a 26-year-old Caucasian woman with spontaneous omental infarction two weeks after normal vaginal delivery. Conclusion Omental infarction is a differential diagnosis in the postpartum acute abdomen. As some cases of omental infarction, which are caused by torsion, can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention. PMID:21083882

  20. A proposed subungual exostosis clinical classification and treatment plan.

    PubMed

    García Carmona, Francisco Javier; Pascual Huerta, Javier; Fernández Morato, Diana

    2009-01-01

    Subungual exostosis is a slow-growing, benign outgrowth of normal bone under the nail that affects the nail unit. The most common location in the foot is the dorsal surface of the distal phalanx of the big toe. Clinically, it can appear in combination with a variety of nail disorders, masking the underlying bone condition, which is frequently unrecognized or misdiagnosed. A new classification system for these lesions is proposed on the basis of the clinical signs and symptoms present during examination and the associated disorders of the nail plate. Also, a therapeutic algorithm that describes surgical approaches to the different presentations of this disorder is presented. PMID:19917738

  1. Primary tubercular mastitis masquerading as malignancy

    PubMed Central

    Prathima, S.; Kalyani, R.; Parimala, S.

    2014-01-01

    The significance of primary tubercular mastitis is due to rare occurrence and often overlooked and misdiagnosed as pyogenic breast abscess or malignancy. Despite the high incidence of tuberculosis in India, reports of breast tuberculosis among the total number of mammary conditions varies between 0.64% and 3.59%. We report a case of a 35-year-old lady with breast lump of 3 months duration, which simulated malignancy on clinical examination but fine needle aspiration cytology revealed granulomatous mastitis secondary to tuberculosis. High level of suspicion and simple fine needle aspiration procedure with micro-biological tests will clinch the final diagnosis. PMID:24678224

  2. Ameloblastic Fibrosarcoma of the Mandible With Distant Metastases.

    PubMed

    Pourdanesh, Fereydoun; Mohamadi, Mansoureh; Moshref, Mohammad; Soltaninia, Omid

    2015-10-01

    Ameloblastic fibrosarcoma is a mixed odontogenic tumor that can originate de novo or from a transformed ameloblastic fibroma. This report describes the case of a 34-year-old woman with a recurrent, rapidly growing, debilitating lesion. This lesion appeared as a large painful mandibular swelling that filled the oral cavity and extended to the infratemporal fossa. The lesion had been previously misdiagnosed as ameloblastoma. Twenty months after final surgery and postoperative chemotherapy, lung metastases were diagnosed after she reported respiratory signs and symptoms. PMID:26207695

  3. Cyst or tumor in the buccomaxillary region: Review of literature and a case report.

    PubMed

    Raheel, Syed Ahmed; Kujan, Omar Bashar; Dwedary, Hisham Mohammed Najeeb; Sikander, Mohammed Hilal; Mankar, Sunil; Amrin, M Nidha

    2015-08-01

    Odontogenic tumors (OTs) include entities of a hamartomatous nature, such as odontoma, benign neoplasms like an adenomatoid odontogenic tumor (AOT), some benign neoplasms are aggressive as in the case of ameloblastoma. The AOT is a rare odontogenic tumor constituting only 3% of all the OT and very often misdiagnosed as an odontogenic cyst. We report a case of an intra-osseous type of AOT occurred in a young 16-year-old female located in the anterior maxilla along with the clinical, radiological, histological features, and literature review related to the tumor affecting the patient. PMID:26538960

  4. Ovarian Sertoli-Leydig Cell Tumour with Heterologus Elements Masquerading as Mucinous Tumour on Frozen Section: A Case Report

    PubMed Central

    Valiathan, Manna; Kumar, Sandeep; Kapoor, Sukriti

    2015-01-01

    Sertoli-Leydig cell tumour (SLCT) is an extremely rare ovarian neoplasm. This tumour is characterized by excessive proliferation of normal testicular structures sertoli and leydig cells. These cells are seen in varying proportions and exhibit varying degrees of differentiation. We report a case of primary ovarian SLCT with heterologus elements in a 17-year-old girl which was misdiagnosed on frozen section as mucinous cystic neoplasm. We discuss the clinicopathologic features of SLCT along with the unusual features seen in this case. PMID:26393134

  5. Reed-Sternberg-like cells in T-cell rich B-cell lymphoma: a diagnostic dilemma.

    PubMed

    Shahabuddin, M D; Raghuveer, C V

    2003-01-01

    T-cell-rich B-cell lymphoma (TCRBCL) is a recently described variant of diffuse Non-Hodgkin's lymphoma (NHL) which requires immunohistochemical analysis for its recognition. Striking similarities exist between TCRBCL and lymphocyte predominant Hodgkin's Disease (LPHD) due to the presence of Reed-Sternberg (R-S) like cells. Hence, the need for distinction between the two is of utmost importance from a prognostic and therapeutic stand point. The present study describes a case of TCRBCL, misdiagnosed as Hodgkin's Disease (HD) on fine needle aspiration (FNA) cytology. However, immunostaining of paraffin embedded sections corrected the cytological diagnosis. PMID:15027722

  6. Neuralgic Amyotrophy Manifesting as Mimicking Posterior Interosseous Nerve Palsy

    PubMed Central

    Yang, Jin Seo; Kang, Suk Hyung; Choi, Eun Hi

    2015-01-01

    The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies. PMID:26713154

  7. Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

    PubMed Central

    Kim, Do Youn; Lee, Seok Jeong; Lee, Jin Hwa; Chang, Jung Hyun; Kim, Yookyung

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory multisystem disease that primarily affects the axial joints. Pleuropulmonary involvement is an uncommon extra-articular manifestation of ankylosing spondylitis. There is a wide spectrum of pulmonary parenchymal changes in ankylosing spondylitis, beginning in the early stages of the disease and increasing over time. The lesions are usually asymptomatic, and not visible on chest radiographs in early stages. We reported a case of advanced ankylosing spondylitis in a 56-year-old man with progressive pulmonary bullous fibrocystic changes on both upper lobes that were misdiagnosed as tuberculosis in the early stages of the disease. PMID:26508946

  8. Diencephalic storms from leptomeningeal metastases and leukoencephalopathy: a rare and clinically important complication.

    PubMed

    Soriano, Aileen; Gutgsell, Terence L; Davis, Mellar P

    2014-02-01

    Diencephalic storms or paroxysmal sympathetic storms are characterized by episodic hyperhidrosis, hypertension, tachypnea, tachycardia, and abnormal posturing. These have been reported to occur in patients with hydrocephalus, intracranial tumors, and hypoxic, ischemic, or traumatic brain injury. They can be easily misdiagnosed as seizures, uncontrolled pheochromocytoma, drug withdrawal, thyroid storm, hypertensive crises, and sepsis or anxiety attacks. The most effective treatment to control these symptoms is yet to be identified. We present 2 individuals exhibiting these sympathetic surges; one whose symptoms were controlled with phenobarbital and the other with clonidine and oxycodone. Palliative medicine physicians should be made aware of this unusual complication. PMID:23298874

  9. Severe Vitamin D Deficiency Causing Kyphoscoliosis

    PubMed Central

    Singhai, Abhishek; Banzal, Subodh

    2013-01-01

    Vitamin D deficiency is common among Indian population. Women are especially at risk for severe vitamin D deficiency. The risk is higher for those who are multiparous and postmenopausal. Poor exposure to sunlight, higher latitude, winter season, inadequate diet, older age, obesity and malabsorption are also important risk factors. Symptoms of hypovitaminosis D, including diffuse or migratory pain affecting several sites (especially the shoulder, pelvis, ribcage and lower back) have also been misdiagnosed as musculoskeletal disorders, including fibromyalgia, polymyalgia rheumatica and ankylosing spondylitis. Here, we report two cases presented with kyphoscoliosis, diagnosed to have severe vitamin D deficiency.

  10. Ultrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome

    PubMed Central

    Nair, Abhijit S.

    2015-01-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time. PMID:26495084

  11. Tuberculosis mimicking lung cancer

    PubMed Central

    Hammen, I.

    2015-01-01

    Tuberculosis (TB) is well known as a diagnostic chameleon and can resemble malignancy. In thorax TB can be manifested as pulmonary infiltrates and/or mediastinal lymphadenopathy. In low incident countries with high incidence of lung cancer and varying clinical presentations, TB often gets misdiagnosed with the result of delayed treatment start and unnecessary diagnostic procedures. Our case report presents two patients, who were referred to the Thorax diagnostic centre at the Department of Respiratory Medicine, Odense University Hospital, with presumptive diagnosis of neoplasm and had proved lung TB with no evidence of malignancy instead. In the first case diagnosis was confirmed after thoracotomy, in the second case after bronchoscopy.

  12. A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy

    PubMed Central

    Rasheed, Asim; Palaria, Urmila; Rani, Dolly; Sharma, Shatrunjay

    2014-01-01

    Negative pressure pulmonary edema is often misdiagnosed or can go clinically unrecognized by anesthesiologists. It is characterized by a markedly low intrapleural pressure which leads to exudation of fluid and red blood cells in the interstitium. Recognition of patients with predisposing factors for upper airway obstruction is important in the diagnosis which is often confused with pulmonary aspiration of gastric contents. Signs and symptoms are subtle and edema is usually self-limited. Our patient was management conservatively with maintenance of a patent airway and administration of supplemental oxygen and had a successful outcome. PMID:25886111

  13. Chronic pancreatic inflammatory granuloma caused by foreign body presenting as a pancreatic pseudotumor: A case report and literature review.

    PubMed

    Wang, Wei-Guo; Zhang, Yi; Wang, Li; Chen, Yang; Tian, Bo-Le

    2015-01-01

    In clinical practical work, a rare kind of chronic pancreatic inflammatory granuloma which is caused by the foreign body of gastrointestinal perforation could be misdiagnosed and treated as pancreatic neoplasm sometimes, and even brings irreparable harm to patients. Here, we depict a male presenting recurrent upper abdominal pain and gradual weight loss, besides, the computer tomography suggested pancreatic tumor strongly. Fortunately, it has been proved to be a chronic pancreatic inflammatory granuloma caused by fish bone through laparotomy finally. To our knowledge, this case is the first case about the chronic pancreatic inflammatory granuloma caused by foreign body which successfully avoids unnecessary pancreatectomy. PMID:26095151

  14. Maslow's Hierarchy of Needs and the individual with chronic vestibular dysfunction.

    PubMed

    Haybach, P J

    1994-01-01

    Individuals with chronic vestibular dysfunction may have unmet physiological or safety needs on a chronic basis. Their inability to fulfill the basic needs and progress to higher needs can lead to a patient population with many psychosocial problems. Very often such problems are ignored or unrecognized or are misdiagnosed, and treated inappropriately. This disruption in the individual's life can lead to an inability to progress as a human being. Nursing assessment and appropriate interventions should be developed to treat psychosocial problems in this patient population. The nursing profession should serve patients with vestibular dysfunction through direct care, teaching, counseling, support group facilitation, and research into appropriate interventions. PMID:8564758

  15. Back pain and spinal metastases: A case study

    PubMed Central

    LaFrance, LJ; Cassidy, JD; Nykoliation, JW; Mierau, DR

    1987-01-01

    Chiropractors see many cases of acute low back pain in daily practice. Since the majority of these cases are suffering from mechanical back pain, it is easy to overlook more sinister, albeit rare, causes of this problem. One such problem is metastatic disease of the spine. Studies have shown that the spine is the most common site of bony metastasis. This report presents two such cases followed by a discussion of how to avoid costly misdiagnoses. ImagesFigure 1Figure 2Figure 3Figure 4

  16. Multidisciplinary management of complex vascular malformation invading bladder wall.

    PubMed

    Norris, Amber K; Richter, Gresham T; Canon, Stephen

    2015-05-01

    A 5-year-old African American male patient, with a history of complex vascular anomalies, underwent treatment for an infiltrating urinary bladder malformation initially misdiagnosed as a rhabdomyosarcoma. Neodymium:yttrium-aluminum-garnet laser was used to treat the bladder wall before surgical resection. Vascular malformations of the bladder are rare. This report demonstrates a multimodal technique for management of large infiltrating bladder venous and lymphatic malformation. At the 3-month follow-up, his symptoms have resolved and his cystoscopy demonstrated no evidence of residual disease. PMID:25770726

  17. Squamous cell carcinoma of the gingiva: A diagnostic enigma

    PubMed Central

    Bharanidharan, R; Dineshkumar, T; Raghavendhar, Karthik; Kumar, A Ramesh

    2015-01-01

    Oral squamous cell carcinoma (OSCC) is the most common epithelial malignant neoplasm affecting the oral cavity; early detection is an important criterion for achieving high cure rate. Occasionally, it may be misdiagnosed because of its variable and innocuous clinical appearance. Carcinomas of the gingiva are a unique subset of OSCC, constituting approximately 10% of OSCCs and can mimic a multitude of oral lesions especially those of inflammatory origin with benign features, often leading to delay in the diagnosis and hence delayed treatment. This article reports a rare case of gingival OSCC in a 62-year-old female patient mimicking an inflammatory gingival mass. PMID:26604512

  18. Fine-Needle Aspiration Cytology of Ewing's Sarcoma of Thoracic Spine with Extension into the Intradural Space

    PubMed Central

    Bordia, Sandhya; Meena, Sweta; Meena, Bijendar Kumar; Rajak, Vijay

    2014-01-01

    Ewing's sarcoma/peripheral primitive neuroectodermal tumor is a small, round, and blue cell malignancy that occurs most often in bone and soft tissues of children and young adults. The intraspinal manifestation of the disease is rare, and when present, this is often misdiagnosed with other varieties of primary spinal tumors. Fine-needle aspiration cytology (FNAC) plays important role in the early diagnosis of these cases. We report such a case of Ewing's sarcoma of thoracic spine with extension into the intradural space, which was initially suspected to be a case of metastatic lesion in an 18-year-old boy. PMID:24847440

  19. Fractures of the thoracolumbar spine: a report of three cases †

    PubMed Central

    Clements, DS; Thiel, HW; Cassidy, JD; Mierau, DR

    1991-01-01

    Thoracolumbar fractures are sometimes misdiagnosed and treated as mechanical low-back pain. This report describes three such cases following flexion-compression injury to the spine. The characteristic presentation along with appropriate examination of the patient are discussed. It is important to consider the possibility of thoracolumbar fracture in the differential diagnosis of low-back pain. ImagesFigure 1Figure 2aFigure 2bFigure 3Figure 4Figure 5aFigure 5bFigure 6Figure 7aFigure 7bFigure 8aFigure 8b

  20. Stiff Man Syndrome: A Diagnostic Dilemma in a Young Female with Diabetes Mellitus and Thyroiditis

    PubMed Central

    Enuh, Hilary; Park, Michael; Ghodasara, Arjun; Arsura, Edward; Nfonoyim, Jay

    2014-01-01

    Stiff Person Syndrome (SPS), is a very rare neuroimmunologic disorder characterized by progressive muscle pain, rigidity, stiffness, and spasms. It can be very debilitating if misdiagnosed or not recognized in time. Herein we discuss a case of a female in her 20s who presented with an unsteady gait, lower extremity weakness, persistent leg pain, and stiffness few weeks after uncomplicated childbirth. She has type 1 diabetes mellitus (DM) and was diagnosed with thyroiditis in the course of her illness. The triad of thyroiditis, DM, and stiffness with normal neuroimaging in a young female patient is an unusual occurrence. PMID:25525403

  1. Ascher syndrome: Review of literature and case report

    PubMed Central

    Ramesh, B. A.

    2011-01-01

    A 13 year old girl presented with aesthetic deformity of upper lip since birth. She also presented with eyelid swelling on and off for 11 months. She was diagnosed to be a rare case of Ascher syndrome. Ascher syndrome commonly presents with double lip and blepharochalasis, sometimes associated with goitre. The deformity of her double upper lip was corrected by appropriate surgery. Because her blepharochalasis is in active stage now, she is under periodic follow up for appropriate intervention. This article describes the management of the patient and brief overview of the syndrome. Ascher syndrome is often missed or misdiagnosed commonly. PMID:21713204

  2. When a respiratory pathogen turns to the skin: cutaneous tuberculosis in a lung transplant patient.

    PubMed

    Voigtländer, Torsten; Cornberg, Markus; Gottlieb, Jens; Welte, Tobias; Suerbaum, Sebastian; Bange, Franz-Christoph

    2015-10-01

    A 62-year-old male, who received immune suppressive therapy due to a lung transplantation several years ago, developed multiple painful abscesses in the right forearm. First misdiagnosed as staphylococcal abscesses, Mycobacterium tuberculosis was eventually cultured from the abscesses. In addition, the patient also suffered from pulmonary tuberculosis and respiratory specimens were also culture-positive for Mycobacterium tuberculosis. Cutaneous tuberculosis must be kept as a differential diagnosis in the case of abscess-like lesions on the skin, especially in immunocompromised patients. Mycobacteria specific tests (polymerase chain reaction in respiratory samples and wound smears) and antituberculotic combination therapy are necessary to treat Mycobacterium tuberculosis infection/reactivation adequately. PMID:25902867

  3. Extranodal natural killer/T cell lymphoma, nasal type presenting as a palatal perforation and naso-oral fistula

    PubMed Central

    Bhatt, Vijaya Raj; Koirala, Bibek; Terjanian, Terenig

    2011-01-01

    Extranodal natural killer/T cell lymphoma (ENKL), nasal type, a rare disease presenting with vague non-specific symptoms, can impose great diagnostic difficulties and may masquerade several infectious, rheumatological or neoplastic conditions. Here, the authors report a case of ENKL presenting as a palatal perforation, naso-oral fistula and fever in a 21-year-old man, which was initially misdiagnosed as bacterial osteomyelitis, invasive fungal infection and Wegener's granulomatosis. The case report underlines the possibility of ENKL occurring at a young age, its rapidly progressive and locally destructive nature, associated diagnostic challenges and the importance of immunophenotyping in establishing the diagnosis. PMID:22707606

  4. Unexpected positron emission tomography-positive actinomyces-related mass of the bronchial stump.

    PubMed

    Andreani, Alessandro; Rossi, Giulio; Giovannini, Michele; Cappiello, Gaia Francesca

    2012-01-01

    Pulmonary actinomycosis is a rare disease frequently misdiagnosed, even by experienced clinicians, as primary or metastatic lung cancer or as other more conventional lung infections. It is often an unexpected disease that is basically detected only on cytological?histological examination. A case involving a patient who presented with a mass in the bronchial stump (of a previous pulmonary lobectomy) is described. Despite a strong suspicion of recurrent lung cancer, positron emission tomography confirmed a diagnosis of a suture-related bronchial actinomycosis. PMID:22536574

  5. Unexpected positron emission tomography-positive Actinomyces-related mass of the bronchial stump

    PubMed Central

    Andreani, Alessandro; Rossi, Giulio; Giovannini, Michele; Cappiello, Gaia Francesca

    2012-01-01

    Pulmonary actinomycosis is a rare disease frequently misdiagnosed, even by experienced clinicians, as primary or metastatic lung cancer or as other more conventional lung infections. It is often an unexpected disease that is basically detected only on cytological/histological examination. A case involving a patient who presented with a mass in the bronchial stump (of a previous pulmonary lobectomy) is described. Despite a strong suspicion of recurrent lung cancer, positron emission tomography confirmed a diagnosis of a suture-related bronchial actinomycosis. PMID:22536574

  6. Frontotemporal dementia mimicking bipolar disorder.

    PubMed

    Kerstein, Andrew H; Schroeder, Ryan W; Baade, Lyle E; Lincoln, Janka; Khan, Ahsan Y

    2013-11-01

    Frontotemporal dementia is a cause of behavioral disturbance that usually appears in individuals between 45 and 65 years of age. The authors present the case of a 65-year-old patient that illustrates how frontotemporal dementia can be misdiagnosed based on a behavioral pattern that suggests the presence of a primary mood disorder. Early accurate diagnosis of frontotemporal dementia and subsequent supportive measures can allow patients and families to make important decisions about business and legal affairs and how to spend remaining leisure time in the most meaningful and enjoyable way possible. PMID:24241504

  7. Recent advances and future prospects in choroideremia

    PubMed Central

    Zinkernagel, Martin S; MacLaren, Robert E

    2015-01-01

    Choroideremia is a complex and rare disease that is frequently misdiagnosed due to its similar appearance to classic retinitis pigmentosa. Recent advances in genetic testing have identified specific genetic mutations in many retinal dystrophies, and the identification of the mutation of the CHM gene on the X chromosome 25 years ago has paved the way for gene replacement therapy with the first human trials now underway. This article reviews the epidemiological and pathological features of choroideremia and new prospects in imaging to monitor disease progression, as well as potential treatment approaches for choroideremia. PMID:26648685

  8. Prevalence, Risk Factors, and Comorbidities of Hidradenitis Suppurativa.

    PubMed

    Miller, Iben Marie; McAndrew, Rachel J; Hamzavi, Iltefat

    2016-01-01

    It is challenging to estimate a true prevalence of hidradenitis suppurativa (HS) because it is underdiagnosed and misdiagnosed. Prevalences have been reported from 0.00033% to 4.1%. The incidence seems to be rising. In addition to dermatologic symptoms, HS is associated with metabolic syndrome, and increased cardiovascular risk. The majority of HS patients are smokers. Additional somatic comorbidities complicating HS include autoimmune conditions, follicular syndromes, rheumatologic conditions, and malignancies. HS patients are troubled by psychological comorbidities. When treating HS patients it is imperative not only to treat the skin symptoms, but also address the screening and treatment of possible comorbidities. PMID:26617352

  9. Disseminated encephalomyelitis-like central nervous system neoplasm in childhood.

    PubMed

    Zhao, Jianhui; Bao, Xinhua; Fu, Na; Ye, Jintang; Li, Ting; Yuan, Yun; Zhang, Chunyu; Zhang, Yao; Zhang, Yuehua; Qin, Jiong; Wu, Xiru

    2014-08-01

    A malignant neoplasm in the central nervous system with diffuse white matter changes on magnetic resonance imaging (MRI) is rare in children. It could be misdiagnosed as acute disseminated encephalomyelitis. This report presents our experience based on 4 patients (3 male, 1 female; aged 7-13 years) whose MRI showed diffuse lesions in white matter and who were initially diagnosed with acute disseminated encephalomyelitis. All of the patients received corticosteroid therapy. After brain biopsy, the patients were diagnosed with gliomatosis cerebri, primitive neuroectodermal tumor and central nervous system lymphoma. We also provide literature reviews and discuss the differentiation of central nervous system neoplasm from acute disseminated encephalomyelitis. PMID:23872916

  10. Paradoxical vocal cord movement during sleep - A unique case with review of literature.

    PubMed

    Sakthivel, Pirabu; Ranipatel, Shikha; Singh, Ishwar; Gulati, Achal

    2015-11-01

    Paradoxical vocal cord movement (PVCM) refers to paradoxical adduction of the true vocal cords during inspiration resulting in variable upper airway obstruction. The condition often presents with shortness of breath, wheeze or stridor, mimicking bronchial asthma. Both organic and non-organic causes have been described. PVCM occurring only during sleep has rarely been reported in patients with CNS disease. We present a case of PVCM occurring only during sleep in a 14-year-old boy without any CNS disease, who was initially misdiagnosed as bronchial asthma. PMID:26318024

  11. Subhallucal Interphalangeal Sesamoiditis: A Rare Cause of Chronic Great Toe Pain

    PubMed Central

    Kadavigere, Rajagopal; Puppala, Radha; Ayachit, Anurag; Singh, Ruchika

    2015-01-01

    Subhallucal interphalangeal sesamoiditis presenting as chronic great toe pain is a rarely reported clinical entity, being often overlooked and misdiagnosed for other pathologies. By altering the biomechanics of the movements at great toe, the interphalangeal sesamoid is prone to various painful pathologies like trauma, infection, degeneration, osteonecrosis and inflammation. Imaging plays an important role in narrowing down the differentials and guiding for appropriate therapy. Herein, we present a neglected case of hallucal interphalangeal sesamoiditis presenting as a case of chronic great toe pain and discuss the role of Magnetic resonance imaging (MRI) and Computed tomography (CT) scan in its diagnosis. PMID:26155529

  12. Cyst or tumor in the buccomaxillary region: Review of literature and a case report

    PubMed Central

    Raheel, Syed Ahmed; Kujan, Omar Bashar; Dwedary, Hisham Mohammed Najeeb; Sikander, Mohammed Hilal; Mankar, Sunil; Amrin, M. Nidha

    2015-01-01

    Odontogenic tumors (OTs) include entities of a hamartomatous nature, such as odontoma, benign neoplasms like an adenomatoid odontogenic tumor (AOT), some benign neoplasms are aggressive as in the case of ameloblastoma. The AOT is a rare odontogenic tumor constituting only 3% of all the OT and very often misdiagnosed as an odontogenic cyst. We report a case of an intra-osseous type of AOT occurred in a young 16-year-old female located in the anterior maxilla along with the clinical, radiological, histological features, and literature review related to the tumor affecting the patient. PMID:26538960

  13. Long-term follow-up of peripheral ossifying fibroma: report of three cases.

    PubMed

    Buduneli, E; Buduneli, N; Unal, T

    2001-01-01

    Peripheral ossifying fibroma is a non-neoplastic enlargement of the gingiva that is classified as a reactive hyperplastic inflammatory lesion. It is possible to misdiagnose peripheral ossifying fibroma as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors. Therefore, histopathological examination is essential for an accurate diagnosis of such lesions. Differential diagnosis is important, because peripheral ossifying fibroma has a tendency to recur. This article describes three cases of peripheral ossifying fibroma, which were followed for 4 years without any sign of recurrence. By presenting these cases, we emphasize the importance of proper excision and aggressive curettage of the adjacent tissues for prevention of recurrence. PMID:11575108

  14. Peripheral ossifying fibroma: a clincal report.

    PubMed

    Sharma, Shivani; Anamika, Sharma; Ramachandra, Srinivas Sulugodu

    2011-06-01

    Peripheral ossifying fibroma (POF) is a common solitary gingival overgrowth thought to arise from the gingival corium, periosteum, and periodontal ligament. Commonly used synonyms for POF include calcifying fibroblastic granuloma, peripheral fibroma with calcification, peripheral cementifying fibroma, and calcifying or ossifying fibrous epulis. Because it is possible to misdiagnose POF as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors, histopathological examination is, therefore, essential for accurate diagnosis, and differential diagnosis is important because of POF's tendency to recur. This article presents a case of peripheral ossifying fibroma in a 15-year-old female along with the clinical, histopathologic, and radiographic features and treatment details. PMID:23738938

  15. Plexiform Unicystic Ameloblastoma: A Rare Variant of Ameloblastoma

    PubMed Central

    Deore, Swapnil S.; Dandekar, Rishikesh C.; Mahajan, Aarti M.; Patil, Rahul; Prakash, Nilima

    2014-01-01

    The term plexiform unicystic ameloblastoma refers to a pattern of epithelial proliferation that has been described in cystic cavity. Because of unilocular presentation, it is commonly misdiagnosed as an odontogenic cyst. However, they may often behave clinically as biologically aggressive tumors. These tumors show high incidence of cortical perforation, tooth resorption and a high rate of recurrence after simple enucleation. This paper aims to provide an insight into this biologically distinct entity. A literature review on the topic has been added along with a case report highlighting the approach of diagnosis and management of such ameloblastomas. PMID:25202458

  16. Monogenic pediatric dyslipidemias: classification, genetics and clinical spectrum.

    PubMed

    Rahalkar, Amit R; Hegele, Robert A

    2008-03-01

    Monogenic disorders that cause abnormal levels of plasma cholesterol and triglycerides have received much attention due to their role in metabolic dysfunction and cardiovascular disease. While these disorders often present clinically during adulthood, some present most commonly in the pediatric population and can have serious consequences if misdiagnosed or untreated. This review provides an overview of monogenic lipid disorders that present with unusually high or low levels of plasma cholesterol and/or triglycerides during infancy, childhood and adolescence. Biochemical and genetic findings, clinical presentation and treatment options are discussed with an emphasis upon recent advances in our understanding and management of these monogenic disorders. PMID:18023224

  17. How Accurate Are We in Detecting Biceps Tendinopathy?

    PubMed

    Carr, Ryan M; Shishani, Yousef; Gobezie, Reuben

    2016-01-01

    Biceps tendon pain is frequently called biceps "tendinitis," or inflammation of the biceps tendon. Histologic analysis of biceps tendon biopsies demonstrates changes in tenocyte size, ground substance, collagen organization, and vascularity observed with many different tendinopathies. There are distinct symptoms of biceps tendinopathy and a few provocative maneuvers can help make the diagnosis. Imaging studies (eg, MRI) can show changes in signal sequence or tears. However, MRI has a low sensitivity and frequently results in missed or misdiagnosed biceps pathology. Clinical decision making is best guided by a strong clinical suspicion based on patient history, physical examination, and MRI. PMID:26614468

  18. Autism spectrum disorders in the DSM-V: better or worse than the DSM-IV?

    PubMed

    Wing, Lorna; Gould, Judith; Gillberg, Christopher

    2011-01-01

    The DSM-V-committee has recently published proposed diagnostic criteria for autism spectrum disorders. We examine these criteria in some detail. We believe that the DSM-committee has overlooked a number of important issues, including social imagination, diagnosis in infancy and adulthood, and the possibility that girls and women with autism may continue to go unrecognised or misdiagnosed under the new manual. We conclude that a number of changes need to be made in order that the DSM-V-criteria might be used reliably and validly in clinical practice and research. PMID:21208775

  19. Submasseteric Infection: A Rare, Deep Space Cheek Infection Causing Trismus.

    PubMed

    Schwartz, Richard H; Bahadori, Robert S; Willis, Andrea

    2015-11-01

    Submasseteric space infections are rare at any age but particularly so in primary school children. The origin of the infection is usually odontogenic, from pericoronitis in a third molar. Submasseteric inflammation is a deep facial space inflammation, often progressing to mature abscess, and usually misdiagnosed as staphylococcal or streptococcal lymphadenitis or pyogenic parotitis. The hallmark of a masticatory space infection is trismus. The cardinal signs of this infection include a firm mass in the body of the masseter muscle with overlying cellulitis with trismus. PMID:25411856

  20. The Management of Neuroleptic-Induced CNS Effects

    PubMed Central

    Hoffman, Brian F.; Seeman, Mary V.

    1981-01-01

    Basal ganglia side effects caused by the neuroleptic drugs include the acute extrapyramidal syndromes (dystonias, akathisia and parkinsonism) and tardive dyskinesia. These may be ignored, misdiagnosed or mistreated by the patient or physician. Because the neuroleptics are effective in the treatment and secondary prevention of serious psychiatric disorders such as schizophrenia, it is important that neurological side effects be anticipated and appropriately managed. This increases patient compliance and enhances the therapeutic relationship. Patients should be examined frequently and systematically for basal ganglia side effects. (Can Fam Physician 1981; 27:1615-1624). PMID:21289825

  1. Anxiety disorders in primary care.

    PubMed

    Combs, Heidi; Markman, Jesse

    2014-09-01

    Anxiety disorders are the most common psychiatric condition presenting to primary care practitioners. Yet they can be easily overlooked or misdiagnosed. Patients that struggle with anxiety disorders are more likely to seek treatment from primary care providers than mental health specialists. Given the costs in terms of debilitation and associated financial burden, and increased risk of suicide, the identification and successful treatment of anxiety is imperative. By means of clinical acumen and the use of screening tools, the provider can develop expertise in recognition and effective treatment of anxiety disorders. PMID:25134870

  2. Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports

    PubMed Central

    2010-01-01

    Panic disorder (PD) is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally, palpitations caused by paroxysmal supraventricular tachycardia (PSVT) are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports, PSVT and PD can occur comorbidly in a chronological sequence, with PSVT possibly precipitating and maintaining PD via interoceptive processes or, alternatively, with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments, potentially helpful differential clinical diagnostic criteria are proposed. PMID:20385011

  3. Unveiling the mystery about adult ADHD: one woman's journey.

    PubMed

    Waite, Roberta; Ivey, Nicole

    2009-09-01

    Attention deficit hyperactivity disorder (ADHD), a neurobiological disorder, affects millions of individuals and can significantly impact an individual's life course. Research guidelines used in assessment, diagnosis, and treatment have focused primarily on Caucasian males generating, in part, the need to redress how gender and other contextual factors are considered. Consequently many women and persons from diverse cultural groups can be ignored or misdiagnosed. Undiagnosed and untreated women with ADHD are therefore limited in their potential to flourish socially, academically, interpersonally, and in their family roles. This case example of a 38-year-old African American woman illustrates how her life journey was affected by undiagnosed ADHD. PMID:19657868

  4. Characterization of the Punta Toro species complex (genus Phlebovirus, family Bunyaviridae).

    PubMed

    Palacios, Gustavo; Wiley, Michael R; Travassos da Rosa, Amelia P A; Guzman, Hilda; Quiroz, Evelia; Savji, Nazir; Carrera, Jean-Paul; Bussetti, Ana Valeria; Ladner, Jason T; Lipkin, W Ian; Tesh, Robert B

    2015-08-01

    Punta Toro virus (PTV), a member of the PTV complex, is a relatively common causative agent of febrile illness in Panama that is often misdiagnosed as 'dengue' or 'influenza'. Currently, only two named members make up this species complex, PTV and Buenaventura virus (BUEV). Genomic and antigenic characterization of 17 members of the PTV complex, nine of which were isolated from human acute febrile illness cases, reveals that this species complex is composed of six distant viruses. We propose to add four additional new viruses, designated Leticia virus, Cocle virus, Campana virus and Capira virus. PMID:25934793

  5. [Scoliosis secondary to tuberculous spondylitis: A case report and discussion of diagnosis].

    PubMed

    Bouillot, L; Kayayan, H; Goiset, E

    2015-12-01

    Idiopathic scoliosis is the most common form of spinal deformity in adolescence. However, secondary causes of scoliosis should always be considered so as to provide appropriate treatment and avoid complications. Additional explorations, such as MRI, are required in the presence of atypical signs. We report a case of spinal tuberculosis, or Pott's disease, misdiagnosed as idiopathic scoliosis, and then present a discussion to help identify the warning signs during the evaluation of scoliosis that might indicate secondary scoliosis and suggest when to perform further radiologic exploration. PMID:26552627

  6. Ultrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome.

    PubMed

    Sahoo, Rajendra Kumar; Nair, Abhijit S

    2015-10-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time. PMID:26495084

  7. Regression of calcinosis following treatment with radiofrequency thermoablation for severe secondary hyperparathyroidism in a hemodialysis patient.

    PubMed

    Wang, Rending; Jiang, Tianan; Chen, Zhimin; Chen, Jianghua

    2013-01-01

    We herein present the case of a 41-year-old man who was misdiagnosed with a recurrent right shoulder tumor and underwent surgery twice. The pathological diagnosis was calcinosis. Secondary hyperparathyroidism was confirmed on further examination and the patient was therefore treated with two sessions of percutaneous ultrasonographically-guided radiofrequency tissue ablation. During the 20-month follow-up, the patient underwent four-hour hemodialysis three times a week. The calcinosis nearly completely resolved, and the PTH level was mildly elevated without the administration of any further medical therapy. Percutaneous ultrasonographically-guided radiofrequency tissue ablation is a feasible, safe and effective nonsurgical alternative treatment for secondary hyperparathyroidism. PMID:23448769

  8. Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: median arcuate ligament syndrome.

    PubMed

    Gunduz, Yasemin; Asil, K?yasettin; Aksoy, Yakup Ersel; Tatl? Ayhan, Laçin

    2014-01-01

    Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case. PMID:25053902

  9. Crowned Dens Syndrome: A Case Report and Review of the Literature

    PubMed Central

    Lee, Gwang Soo; Park, Hyung Ki; Chang, Jae Chil

    2014-01-01

    The crowned dens syndrome (CDS), also known as periodontoid calcium pyrophosphate dehydrate crystal deposition disease, is typified clinically by severe cervical pain, neck stiffness and atlantoaxial synovial calcification which could be misdiagnosed as meningitis, epidural abscess, polymyalgia rheumatica, giant cell arthritis, rheumatoid arthritis, cervical spondylitis or metastatic spinal tumor. Crystalline deposition on cervical vertebrae is less well known disease entity and only a limited number of cases have been reported to date. Authors report a case of CDS and describe the clinical feature. PMID:24891867

  10. Borrelia miyamotoi Disease: Neither Lyme Disease Nor Relapsing Fever.

    PubMed

    Telford, Sam R; Goethert, Heidi K; Molloy, Philip J; Berardi, Victor P; Chowdri, Hanumara Ram; Gugliotta, Joseph L; Lepore, Timothy J

    2015-12-01

    Borrelia miyamotoi disease (BMD) is a newly recognized borreliosis globally transmitted by ticks of the Ixodes persulcatus species complex. Once considered to be a tick symbiont with no public health implications, B miyamotoi is increasingly recognized as the agent of a nonspecific febrile illness often misdiagnosed as acute Lyme disease without rash, or as ehrlichiosis. The frequency of its diagnosis in the northeastern United States is similar to that of human granulocytic ehrlichiosis. A diagnosis of BMD is confirmed by polymerase chain reaction analysis of acute blood samples, or by seroconversion using a recombinant glycerophosphodiester phosphodiesterase enzyme immunoassay. BMD is successfully treated with oral doxycycline or amoxicillin. PMID:26593262

  11. Xanthogranulomatous pyelonephritis with unconnected liver lesion.

    PubMed

    Karaman, Abdurrahman; Samdanc?, Emine; Do?an, Metin; Aksoy, Rauf Tu?rul; S???rc?, Ahmet; Demircan, Mehmet

    2011-07-01

    Xanthogranulomatous pyelonephritis is a chronic renal inflammation characterized by destruction and replacement of its parenchyma with granulomatous tissue. This uncommon condition is rare in children. We report on a 5-month-old male infant with a left renal and hepatic mass detected by ultrasound. The case was preoperatively misdiagnosed as Wilms' tumor and total nephrectomy and biopsy from liver lesion were performed. The subsequent histopathological findings confirmed the diagnosis of xanthogranulomatous pyelonephritis for renal and liver lesions. Increasing awareness of this disease should lead to the diagnosis being suspected preoperatively even if it is with unconnected tissue lesions. PMID:21094988

  12. Primary Peritoneal Hydatid Cyst Presenting as Ovarian Cyst Torsion: A Rare Case Report

    PubMed Central

    Gandhiraman, Kavitha; Balakrishnan, Renukadevi; Ramamoorthy, Rathna; Rajeshwari, Raja

    2015-01-01

    Hydatid cyst disease is a zoonotic disease caused by Echinococcus granulosus, E.multilocularis or E.Vogli. The most common primary site is liver (75%) followed by lungs (5-15%) and other organs constitute 10-20%. Peritoneal hydatid cysts are very rare especially primary peritoneal hydatid. Secondary peritoneal hydatid cysts are relatively common, which usually occurs due to rupture of primary hepatic hydatid cyst. We present a rare case of large primary peritoneal hydatid cyst misdiagnosed as torsion of ovarian cyst that underwent Laparotomy with cyst excision and postoperative Albendazole therapy. PMID:26436004

  13. Disseminated Alveolar Hydatid Disease Resembling a Metastatic Malignancy: A Diagnostic Challenge—A Report of Two Cases

    PubMed Central

    Bulakci, Mesut; Cengel, Ferhat; Gocmez, Ahmet; Kartal, Merve Gulbiz; Isik, Emine Goknur; Celenk, Erhan

    2014-01-01

    Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite Echinococcus multilocularis that is potentially fatal if left untreated. It primarily involves the liver but can be disseminated to other organs like the lungs and the brain by hematogenous route. Multiorgan involvement and the aggressive appearance of lesions make alveolar hydatid disease easy to confuse with a metastatic malignancy. For this reason, histopathological confirmation is essential for definite diagnosis. We present the imaging features of this disease in two patients in order to emphasize that these lesions can be easily misdiagnosed as malignancies. PMID:25374743

  14. Rare Skeletal Complications in the Setting of Primary Hyperparathyroidism

    PubMed Central

    Sabanis, Nikos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Papanikolaou, Dimitrios; Ioannidou, Pinelopi; Vasileiou, Sotirios

    2015-01-01

    Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations which vary from asymptomatic patients to severe complications of hypercalcemia or parathyrotoxicosis while skeletal involvement is rather common. Herein we aimed at presenting a unique case of a young patient with rare aggressive skeletal complications of parathyroid cancer that initially were misdiagnosed. Ossification of the cervical ligamentum flavum and skull tumor illustrates erosive bonny lesions of hyperparathyroidism that in association with previous medical history of recurrent nephrolithiasis and biochemical findings guide the diagnosis. We suggest that increased awareness and holistic approach are needed in order to recognize and further investigate signs and symptoms of hyperparathyroidism. PMID:26664767

  15. Entrapment Neuropathies of the Foot and Ankle.

    PubMed

    Ferkel, Eric; Davis, William Hodges; Ellington, John Kent

    2015-10-01

    Posterior tarsal tunnel syndrome is the result of compression of the posterior tibial nerve. Anterior tarsal tunnel syndrome (entrapment of the deep peroneal nerve) typically presents with pain radiating to the first dorsal web space. Distal tarsal tunnel syndrome results from entrapment of the first branch of the lateral plantar nerve and is often misdiagnosed initially as plantar fasciitis. Medial plantar nerve compression is seen most often in running athletes, typically with pain radiating to the medial arch. Morton neuroma is often seen in athletes who place their metatarsal arches repetitively in excessive hyperextension. PMID:26409596

  16. Magnetic resonance imaging of pelvic floor dysfunction.

    PubMed

    Lalwani, Neeraj; Moshiri, Mariam; Lee, Jean H; Bhargava, Puneet; Dighe, Manjiri K

    2013-11-01

    Pelvic floor dysfunction is largely a complex problem of multiparous and postmenopausal women and is associated with pelvic floor or organ descent. Physical examination can underestimate the extent of the dysfunction and misdiagnose the disorders. Functional magnetic resonance (MR) imaging is emerging as a promising tool to evaluate the dynamics of the pelvic floor and use for surgical triage and operative planning. This article reviews the anatomy and pathology of pelvic floor dysfunction, typical imaging findings, and the current role of functional MR imaging. PMID:24210448

  17. Differentiating between red legs and cellulitis and reviewing treatment options.

    PubMed

    Salmon, Michelle

    2015-10-01

    Red legs (RL) is a chronic inflammatory condition often misdiagnosed as cellulitis. Antibiotic therapy is not required and does not resolve the symptoms. The main causes of RL are chronic dermatological and venous disease, including chronic oedema. Raising awareness of this condition among health professionals could prevent misdiagnosis and unnecessary costly and potentially harmful antibiotic therapy. The aim of this paper is to highlight the differential diagnoses and management of red legs, and the author also includes an example through a case history. PMID:26418399

  18. [Prevention of genito-anal and bucco-laryngo-esophageal cancers caused by sexually transmitted viruses].

    PubMed

    Mathé, G

    1985-01-01

    Whilst some viruses of the Papilloma family cause warts on the skin, others infect mucosal cells. The types called 6 and 11 produce benign papillomas, called condylomata acuminata, visible to the naked eye, not only on the vulva, vagina, penis (cockscomb), but also in the anus, and occasionally the larynx, mouth (tongue) and oesophagus. Types 16 and 18 cause cervical cancer (generally called in situ) and especially very small flat lesions that can only be seen through the colposcope in women and a lens in men. These flat micro-lesions can also be found on the vulva, vaginal walls and on the glans and, balano-preputial area and shaft in males, the distal urethra, anus, larynx (especially the vocal cords), the mouth and oesophagus. These flat micro-lesions are either early cancers (here the deoxyribonucleic acid (DNA) of the virus 16 and/or 18 is integrated into the cell genome), or precancerous lesion in which case the viral DNA is not integrated. Their malignant transformation is much more frequent at the junction of the glandular and squamous parts of the cervix, than in the vulva or vagina. Co-carcinogenic factors appear to have an important role in the malignant transformation;--as for instance sexually transmissible infections including chlamydiae, bacteria that produce carcinogens such as nitrosamines, herpes virus which is known to cause mutations predisposing to the integration of the Papova viruses, chemical substances applied to the genitalia. The role of low hygiene standards in male sexual partners is the major cause (such men can carry simultaneously several sexually transmissible diseases (STD], who are never examined in search for flat lesions, who do not seek medical advice and have multiple sexual contacts with many women among whom some are more dangerous than prostitutes, especially since the wide use of hormone contraceptives and abortion that has multiplied the incidence of cervical cancer by 3 among the 20 year-old females, by 4 among the 25 year-old ones and by 2.5 among the 30 year-old ones, between 1961-65 and 1982-83. These changes in contraception have now made intra-vaginal ejaculation the rule (this not only carries viruses and other micro-organisms into the female genital tract, but also deposits sperm that contains some thirty factors that suppress local immunity). This with the rise of multiple partners, early sexual activity in particular in girls (hardly post-puberty) explains the increase of the frequency of cervical cancer in younger and younger women.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3002511

  19. Comparison of the Clinical Manifestations between Acute Vogt-Koyanagi-Harada Disease and Acute Bilateral Central Serous Chorioretinopathy

    PubMed Central

    Shin, Woo Beom; Kim, Min Kyo; Lee, Christopher Seungkyu; Lee, Sung Chul

    2015-01-01

    Purpose To compare clinical, angiographic, and optical coherence tomographic characteristics between eyes with acute Vogt-Koyanagi-Harada (VKH) disease and eyes with acute bilateral central serous chorioretinopathy (CSC), and to demonstrate distinguishing features between the two diseases in confusing cases. Methods The medical records of 35 patients with VKH disease and 25 patients with bilateral CSC were retrospectively reviewed. Characteristics according to slit-lamp biomicroscopy, ophthalmoscopy, fundus photography, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography were compared between the two diseases. Results Five of 35 patients (10 of 70 eyes, 14.3%) with VKH disease were initially misdiagnosed as CSC patients, and six of 25 patients (12 of 50 eyes, 24%) with bilateral CSC were initially misdiagnosed as patients with VKH disease. Pigment epithelial detachment in CSC and optic disc hyperemia in VKH disease show the highest positive predictive values of 100% for each disease. Conclusions Optic disc hyperemia in VKH disease and pigment epithelial detachment in bilateral CSC are the most specific clinical manifestations of each disease at initial patient presentation. PMID:26635455

  20. Sudden Death Due to Traumatic Ascending Aortic Pseudoaneurysms Ruptured Into the Esophagus

    PubMed Central

    He, Shixia; Chen, Xiaorui; Zhou, Xiaowei; Hu, Qingqing; Ananda, Sunnassee; Zhu, Shaohua

    2015-01-01

    Abstract We present 2 rare cases of patients with uncontrolled hemorrhagic shock induced by traumatic ascending aortic pseudoaneurysm rupture into the esophagus. Two men were presented to the hospital after traffic accidents. Their chest radiograph showed no obvious signs of aortic damage or aortic pseudoaneurysms but only a small amount of high-density shadow in the mediastinum and no specific clinical signs besides chest tightness or chest tenderness. The first case was misdiagnosed as pulmonary contusion and pleural effusion, and the second case was misdiagnosed as mediastinal lesions in the mediastina. They were given symptomatic and supportive treatment. Unfortunately, they died suddenly after >1 month of traumatic accident. At autopsy, ascending aortic pseudoaneurysms that broke into the esophagus and multiple organ hematocele were detected by gross examination. In histopathological examination, inflammatory cells and proliferated fibrous connective tissue were detected in the ascending aortic pseudoaneurysms, and the pathological gastrointestinal bleeding was not seen. The drugs and poisons were not found on toxicological analysis. The 2 patients died as a result of hemorrhagic shock from traumatic ascending aortic pseudoaneurysm rupture into the esophagus. We suggest that thoracic surgeon should be aware of the possibility of aortic injury after chest trauma to reduce misdiagnosis and prevent similar accidents. PMID:25881850

  1. Cytologic findings of a clear cell parathyroid lesion.

    PubMed

    Papanicolau-Sengos, Antonios; Brumund, Kevin; Lin, Grace; Hasteh, Farnaz

    2013-08-01

    On fine-needle aspiration (FNA) biopsy, clear cell parathyroid lesions can be misdiagnosed as thyroid neoplasms, salivary gland neoplasms, paraganglioma, or even metastatic renal cell carcinoma. We report the clinicopathological, cytologic, and histologic findings of a clear cell parathyroid tumor in a 64-year-old HIV-positive patient. A computed tomography (CT) scan with contrast showed a heterogeneous and enhancing mass at the inferolateral aspect of the left thyroid lobe. FNA showed a cellular smear with many single and loosely clustered tumor cells with finely granular and vacuolated light-purple cytoplasm and central nuclei. Occasional microfollicular structures were noted. No colloid was seen. This FNA was misdiagnosed as a follicular neoplasm of the thyroid. Sections of the excised mass showed large polyhedral cells with well-defined cell membranes and clear cytoplasm with a small amount of eosinophilic granular material. These clear cells were positive for pancytokeratin and PTH immunohistochemical stains. These results favored a diagnosis of parathyroid Water Clear Cell Adenoma. This brief report highlights the cytologic findings of clear cell parathyroid lesions and their potential diagnostic pitfalls. PMID:22144114

  2. Endoscopic clipping of the Z-line (CMZL) helps recognize anatomical failures after Nissen fundoplication: technical report of a new method

    PubMed Central

    Kazaryan, Airazat M.; Aasen, Steinar; Edwin, Bjørn

    2015-01-01

    Introduction Nearly 15% of patients after laparoscopic antireflux surgery experience recurrence of symptoms or develop new gastrointestinal symptoms. Some of them require redo procedures. It can be demanding to reveal anatomical failure after previous fundoplication. Aim To present a method which assists in recognition of anatomical failures after Nissen fundoplication. Material and methods Five patients with previous laparoscopic Nissen fundoplication and severe gastrointestinal symptoms were included in this study. During the esophagogastroduodenoscopy (EGDS) two radiopaque metal clips were placed to mark the Z-line (“clips-marked Z-line” – CMZL). It was done to achieve precise visualization of the gastroesophageal junction area in the video contrast investigation. Distinctions between conclusions after the EGDS, ordinary video contrast investigation, video contrast investigation with CMZL and intraoperative findings were analyzed. Results All patients underwent laparoscopic refundoplication with good postoperative results. There were 4 cases misdiagnosed by contrast investigation without clips and four cases misdiagnosed by EGDS. Endoscopic clipping helped to recognize correctly all anatomical failures. Conclusions Applying CMZL as a routine investigation before redo fundoplication can reduce frequency of misdiagnosis and help to perform redo fundoplication in appropriate patients, but it requires further studies on larger cohorts of patients.

  3. Giant Pulmonary Hydatid Cyst and Trauma in a 9 Year-Old Child: A Case Report

    PubMed Central

    Sokouti, Mohsen; Shokouhi, Behrooz; Sokouti, Massoud; Sokouti, Babak

    2015-01-01

    Herein, we report a case of giant lung hydatid cyst in a nine-year-old boy. For four years, he experienced mild chest pain and chronic nonproductive cough. He had a trauma resulted from a fall two days before admission. Chest X-ray showed misdiagnosed massive pleural effusion, and was aspirated in the other hospital. However, after admission, the computed tomography revealed a giant lung hydatid cyst filling the right hemithorax completely. Being considered by the diagnosis of ruptured lung hydatid cyst, he was treated surgically by right-thoracotomy. The existing hydatid cyst, (e.g., with a dimension of 30*22*20cm) filled all cavity of hemithorax extended from the right diaphragm to the apex of the lung situated in the right lower lobe. After evacuation of the hydatid fluid and laminated membrane, right lower lobectomy was carried out due to remaining no salvageable parenchyma without any complications. Also, the pathologic examination have confirmed hydatid cyst. In conclusion, giant hydatid cysts are probably misdiagnosed with massive pleural effusion in the endemic area. And, because of the risk of allergic reactions, anaphylactic shock and dissemination, it should not be aspirated. PMID:26089993

  4. Trigeminal neuralgia--case and treatment analysis at the Department of Oral Surgery of the University Hospital Dubrava.

    PubMed

    Peri?, Berislav; Zore, Irina Filipovi?; Vidakovi?, Bruno; Joki?, Drazen; Cabov, Tomislav; Sarac, Helena

    2014-06-01

    The aim of the study was to explore certain risk factors for trigeminal neuralgia (TN), assess the prevalence of misdiagnoses of TN made by primary care dentists, compare the treatment practice for TN at the Department of Oral Surgery with the guidelines, and the importance of interdisciplinary approach in TN treatment. The study included 237 patient records (70 men and 167 women, aged 5-91 years) referred to the Department under the diagnosis of TN. From their medical records, demographic data, referral diagnose, clinical diagnose, additional diagnostic procedures and treatment were analysed. Neuralgia of the trigeminal nerve affects predominantly elderly female population, while the impact of the season on the incidence of the disease has not been determined. The most common therapy used at the Department were blockades, carbamazepine or their combination. 63.3% patients were referred for further diagnostic tests following the first examination. The number of misdiagnosed cases referred by primary care dentists (33.6%) points that better training in diagnosing TN is needed for the dental practitioners. The treatment methods at the Department need to be harmonized with the latest guidelines on neuralgia treatment. Due to the complexity of etiological factors, an interdisciplinary approach is necessary. PMID:25145008

  5. Extent and consequences of physician delay in the diagnosis of acral melanoma.

    PubMed

    Metzger, S; Ellwanger, U; Stroebel, W; Schiebel, U; Rassner, G; Fierlbeck, G

    1998-04-01

    The extent and consequences of professional delay in diagnosis were analysed in 83 patients with palmoplantar and subungual melanomas treated from January 1986 to March 1997 in our department. Seventeen (52%) out of 33 subungual melanomas and 10 (20%) out of 50 palmoplantar melanomas were clinically misdiagnosed by physicians. Three palmoplantar melanomas (6%) were initially misinterpreted by pathologists. In 23 of the 27 cases (85%) the clinical misdiagnosis was made by non-dermatologists. Misdiagnosis caused a median delay of 12 months in the diagnosis of palmoplantar melanomas and 18 months in the diagnosis of subungual melanomas. Delay in diagnosis was associated with increased tumour thickness, more advanced stage at time of melanoma diagnosis and a lower estimated 5-year survival rate (15.4% versus 68.9% for palmoplantar; 68.5% versus 90.9% for subungual). Acral melanomas are frequently misdiagnosed due to their less common locations and because plantar and subungual melanomas often do not fit the 'changing mole' pattern. To Improve the patient's prognosis it is necessary to increase the physicians' skill in the diagnosis of acral melanomas. Histological examination should always be performed in acral lesions that do not heal. PMID:9610874

  6. Severe eosinophilia in children: a diagnostic dilemma.

    PubMed

    Amshalom, Annat; Lev, Atar; Trakhtenbrot, Luba; Golan, Hana; Weiss, Batia; Amariglio, Ninette; Rechavi, Gideon; Somech, Raz

    2013-05-01

    The differential diagnosis of hypereosinophilia includes both primary (clonal and idiopathic) and secondary medical conditions. Here we raise the awareness of physicians to the unusual causes of hypereosinophilic states and describe the molecular assays used in the diagnosis of hypereosinophilia. Two unusual cases of hypereosinophilia in children that were initially misdiagnosed are reported. T-cell receptor gene rearrangement, skewed X inactivation, fluorescence in situ hybridization analysis, and chromosomal karyotyping were used to reach the final correct diagnosis. Both patients displayed significant eosinophilia and were initially misdiagnosed as having parasitic infection. Nonspecific T-cell clonal expansion was diagnosed in 1 patient based on the clonality of the T-cell receptor variable ?-chain and the skewed chromosome inactivation. The second patient was diagnosed with B-lineage acute lymphoblastic leukemia with a translocation (5;14) (q13;q32) that is well known to be associated with hypereosinophilia. The level of awareness to clonal expansion of WBC subsets which can cause hypereosinophilia should be high when evaluating a patient with extreme eosinophilia. Advanced molecular assays to detect clonal expansion should be used to exclude aberrant clonal processes in such patients. PMID:23612381

  7. Rapid Detection of Herpes Viruses for Clinical Applications

    NASA Technical Reports Server (NTRS)

    Pierson, Duane; Mehta, Satish

    2013-01-01

    There are eight herpes viruses that infect humans, causing a wide range of diseases resulting in considerable morbidity and associated costs. Varicella zoster virus (VZV) is a human herpes virus that causes chickenpox in children and shingles in adults. Approximately 1,000,000 new cases of shingles occur each year; post-herpetic neuralgia (PHN) follows shingles in 100,000 to 200,000 people annually. PHN is characterized by debilitating, nearly unbearable pain for weeks, months, and even years. The onset of shingles is characterized by pain, followed by the zoster rash, leading to blisters and severe pain. The problem is that in the early stages, shingles can be difficult to diagnose; chickenpox in adults can be equally difficult to diagnose. As a result, both diseases can be misdiagnosed (false positive/negative). A molecular assay has been adapted for use in diagnosing VZV diseases. The polymerase chain reaction (PCR) assay is a non-invasive, rapid, sensitive, and highly specific method for VZV DNA detection. It provides unequivocal results and can effectively end misdiagnoses. This is an approximately two-hour assay that allows unequivocal diagnosis and rapid antiviral drug intervention. It has been demonstrated that rapid intervention can prevent full development of the disease, resulting in reduced likelihood of PHN. The technology was extended to shingles patients and demonstrated that VZV is shed in saliva and blood of all shingles patients. The amount of VZV in saliva parallels the medical outcome.

  8. Congenital Epulis: A Rare Benign Jaw Tumour in a 2-Day-Old Male Baby

    PubMed Central

    Bhoil, Rohan; Bhoil, Rohit; Chopra, Rajesh; Sharma, Manika; Mistry, Kewal

    2015-01-01

    Summary Background Congenital epulis is a rare benign jaw tumor. It is a reactive or degenerative lesion having a mesenchymal origin; presenting as an obvious mass arising from the gingival mucosa of the maxilla or mandible, presenting in neonates. Its etiology, histopathogenesis and natural history are still not well established. It is seen usually in the female gender and mostly involves the maxillary alveolar ridge. Material/Mehods We report a case of a 2.7 kg male baby born with growth on his mandibular ridge which was excised and was proved to be epulis on histopathology. Results Congenital epulis is often misdiagnosed before surgery because of its rarity and a lack of awareness of the condition by clinicians. It is important for the attending pediatricians, pediatric surgeon to be aware of this rare but benign congenital tumor. Conclusions Congenital epulis is often misdiagnosed before surgery because of its rarity and a lack of awareness of the condition by clinicians. As the clinical presentation of this congenital tumor can be distressing due to its size and aggressive appearance, it is important for the attending pediatricians, pediatric surgeon to be aware of this rare but benign congenital tumor. PMID:26379808

  9. Oral Manifestations of Chronic Renal Failure Complicating a Systemic Genetic Disease: Diagnostic Dilemma. Case Report and Literature Review.

    PubMed

    Benmoussa, Leila; Renoux, Marion; Radoï, Loredana

    2015-11-01

    Chronic renal failure can give rise to a wide spectrum of oral manifestations, owing mainly to secondary hyperparathyroidism complicating this disease. However, any systemic disease responsible for kidney failure can produce oral manifestations, which can be misdiagnosed. This report describes the case of a 40-year-old male patient referred for oral assessment before kidney and liver transplantation. He had primary hyperoxaluria complicated by end-stage renal failure and secondary hyperparathyroidism. Panoramic radiography indicated not only external root resorption, but also maxillary and mandibular radiolucencies consistent with brown tumors. Unexpectedly, histologic study of the bone biopsy specimen led to the diagnosis of jaws oxalosis. Primary hyperoxaluria is a systemic genetic disease. The affected genes are involved in glyoxylate metabolism and their deficiency results in overproduction of oxalates. Inability of the kidney to excrete oxalates leads to deposition of these crystals in almost all tissues (oxalosis) and to multiple-organ failure. Several oral findings have been described in patients with oxalosis, such as periodontal disease and root resorptions, but radiolucencies in the jaws have rarely been described. This case report is of particular interest because of the unusual location of oxalate crystal deposition in the jaws, which could be misdiagnosed in a patient with renal failure and secondary hyperparathyroidism. PMID:26071361

  10. Respiratory dyskinesia--an under-recognized side-effect of neuroleptic medications.

    PubMed

    Bhimanil, Mukesh Mohan; Bhimani, Mukesh; Khan, Murad Moosa; Khan, Muhammad Faheem Ashraf; Waris, Muhammad Shiraz

    2011-09-01

    Respiratory dyskinesia is an under-recognized side effect of neuroleptic administration. There are only few studies that have addressed the prevalence of respiratory dyskinesia in patients with tardive dyskinesia. Our case report highlights the need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature. Since RD is underrecognized and misdiagnosed, early detection can improve long term prognosis as treatment options are few and usually of only limited effect. A 62-year-old Asian male, retired civil engineer, had more than 20 years history of depressive illness, developed antidepressant induced hypomania, and was given risperidone upto 1 mg per day. He developed extrapyrmidal side effects as tremors, rigidity and later dyskinetic movements of lips with shortness of breathing, dyspnoea, grunting or gasping. He was referred to the pulmonologist who got the neccessary medical work up done, which was normal. A diagnosis of respiratory dyskinesia was made. Respiratory dyskinesia is an under-recognised and distressing condition that clinicians need to be aware of when treating patients with anti-psychotic medications. And also there is a need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature for early diagnosis and better outcome. This case report also is worth reading for professionals of other specialties also because of the presentation of this patient, it can be easily misdiagnosed and result in poor outcome. PMID:22360044

  11. Pruritus in Female Patients

    PubMed Central

    Lambert, Julien

    2014-01-01

    Pruritus is a frequent symptom in many dermatological diseases. In this review we want to focus on not only itch problems specific to women, namely, pruritic vulvodermatoses, but also the specific pruritic dermatoses of pregnancy. The specific characteristics of the vulva and the hormonal changes during the different age periods make these dermatoses very particular. It seems that vulvar diseases are still underdiagnosed and undertreated. Pruritic vulvar diseases have a huge impact on quality of life. The most common pruritic diseases will be discussed, such as atopic and contact dermatitis, psoriasis, lichen sclerosis, lichen planus, and infectious vulvaginitis. We focus on the diagnostic issue of these diseases and will consider the general principles of therapy. PMID:24711996

  12. Labia Minora, Labia Majora, and Clitoral Hood Alteration: Experience-Based Recommendations.

    PubMed

    Hunter, John G

    2016-01-01

    Aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva. Although the labia minora are usually the focus of concern, the entire anatomic region-minora, labia majora, clitoral hood, perineum, and mons pubis-should be evaluated in a preoperative assessment of women seeking labiaplasty. Labiaplasty is associated with high patient satisfaction and low complication rates. The three basic labia minora reduction techniques-edge excision, wedge excision, and central deepithelialization-as well as their advantages and disadvantages are discussed to assist the surgeon in tailoring technique selection to individual genital anatomy and aesthetic desires. We present key points of the preoperative anatomic evaluation, technique selection, operative risks, perioperative care, and potential complications for labia minora, labia majora, and clitoral hood alterations, based on a large operative experience. Labiaplasty competency should be part of the skill set of all plastic surgeons. PMID:26499942

  13. Description of Thecavermiculatus andinus n.sp. (Meloidoderidae), a Round Cystoid Nematode from the Andes Mountains of Peru

    PubMed Central

    Golden, A. M.; Franco, J.; Jatala, P.; Astogaza, E.

    1983-01-01

    Thecavermiculatus andinus n.sp. is described and illustrated from Oxalis tuberosa originally collected in the vicinity of Lake Titicaca high in the Andes mountains of southern Peru. This new species differs markedly front the other two species in the genus, especially in having a much greater female vulval-anal distance and annules with lined punctation on most of the female body with a lacelike pattern restricted to the posterior portion, particularly at the vulva and anus which do not protrude. Females are essentially spherical with protruding neck, white to yellowish in color, and can easily be mistaken for potato cyst nematodes. Among the dozen or more known weed and crop host plants are potato and eggplant. In order to accommodate this new species, the genus Thecavermieulatus is emended. A key to the species of this genus is presented. PMID:19295818

  14. The external genitalia of female gibbons, Hylobates (H.) lar.

    PubMed

    Dahl, J F; Nadler, R D

    1992-04-01

    The external genitalia of one perimenarcheal and five adult female white handed-gibbons (Hylobates (H.) lar) were examined to clarify their gross anatomy. It was found that the vulval structures were complex and exhibited inter-individual variation in arrangement. This complexity appears to result from an ontogenetic process by which the tissues of the vaginal rim (the labia minora) bud-off and extrude extensions toward the vagina immediately prior and subsequent to menarche. Two of these lobular structures surround the urethral meatus and constitute a urethral eminence. The tissues of the vulva, excluding the clitoris with associated prepuce and frenulum and vestigial labia majora, undergo cycles of tumescence and detumescence during intermenstrual intervals. The complex form of the external genitalia and the presence of a swelling cycle are unusual for a monogamous species, are contrary to current applications of sexual selection theory, and raise questions about the significance of mate choice in hominoid evolution. PMID:1554106

  15. Primary cardiac malignant fibrous histiocytoma with vulvar metastases: A case report

    PubMed Central

    SUN, JUNJIE; LIU, RUIHUA; WANG, WEIWEI; SUN, MINGHUI; WANG, LIHONG; WANG, XIAOFEI; SHI, LEI

    2015-01-01

    Malignant fibrous histiocytoma (MFH) occurring in the heart is rare. To the best of our knowledge, the current study was the first to report a case of left atrial MFH metastasizing to the vulva. A 37-year-old female presenting with a history of exertional dyspnea underwent echocardiography, which revealed a mass in the left atrium, with a short-wide stalk attached to the posterior wall, extending into the pericardium. Furthermore, the mass resulted in severe mitral stenosis during diastole. The tumor was excised together with a section of the left atrial wall. The initial diagnosis was a left atrial myxoma. However, post-operative frozen section histopathology results indicated a diagnosis of MFH. Following surgery, the patient received chemotherapy, however, vulvar metastases and left pleural effusions were identified after 1 month. Following surgical excision of the vulvar tumor and left thoracentesis, the patient began adjuvant chemotherapy. However, the patient succumbed due to local recurrence 6 months later. PMID:26722303

  16. A Forward Genetic Screen for Suppressors of Somatic P Granules in Caenorhabditis elegans

    PubMed Central

    Kelly, Ashley L.; Senter-Zapata, Michael J.; Campbell, Anne C.; Lust, Hannah E.; Theriault, Monique E.; Andralojc, Karolina M.; Updike, Dustin L.

    2015-01-01

    In Caenorhabditis elegans, germline expression programs are actively repressed in somatic tissue by components of the synMuv (synthetic multi-vulva) B chromatin remodeling complex, which include homologs of tumor suppressors Retinoblastoma (Rb/LIN-35) and Malignant Brain Tumor (MBT/LIN-61). However, the full scope of pathways that suppress germline expression in the soma is unknown. To address this, we performed a mutagenesis and screened for somatic expression of GFP-tagged PGL-1, a core P-granule nucleating protein. Eight alleles were isolated from 4000 haploid genomes. Five of these alleles exhibit a synMuv phenotype, whereas the remaining three were identified as hypomorphic alleles of known synMuv B genes, lin-13 and dpl-1. These findings suggest that most suppressors of germline programs in the soma of C. elegans are either required for viability or function through synMuv B chromatin regulation. PMID:26100681

  17. Recent Developments in Non-HPV-related Adenocarcinomas of the Lower Female Genital Tract and Their Precursors.

    PubMed

    McCluggage, W Glenn

    2016-01-01

    Most adenocarcinomas in the lower female genital tract (cervix, vagina, vulva) arise in the cervix and are associated with high-risk human papillomavirus (HPV) infection. However, there is an emerging spectrum of non-HPV-related cervical adenocarcinomas, the most common of which is so-called gastric type. In this review, the concept of gastric-type cervical adenocarcinomas and their possible precursor lesions is covered, the precursor lesions still being poorly understood. Other non-HPV-related cervical adenocarcinomas are also discussed, including new information regarding molecular events in mesonephric adenocarcinoma. A variety of primary vaginal adenocarcinomas, including clear cell, endometrioid, intestinal and gastric types are also discussed. The spectrum of benign and malignant glandular lesions involving the lower female genital tract and probably derived from misplaced Skene's (periurethral) glands is also covered. PMID:26645463

  18. Urogenital Applications of Probiotic Bacteria

    NASA Astrophysics Data System (ADS)

    Reid, Gregor

    The urogenital tract extends from the perineal skin close to the anus, to the vulva, vagina, cervix, uterus, urethra, bladder and kidneys. The uterus, bladder and kidneys are regarded as being sterile, although it will not be surprising if molecular techniques discover that this is not necessarily the case. The importance of the urogenital tract in the health of women cannot be understated. Given its proximity to potential pathogens emerging from the rectum, exposure to sexually transmitted organisms, hormonal fluctuations that affect cells, use of tampons, contraceptives and douches, and the birthing process, it is remarkable that this area is not constantly infected. Nevertheless, it has been estimated that almost every female will have a vaginal or bladder infection at some point in her life.

  19. A new ladybird spider from Hungary (Araneae, Eresidae)

    PubMed Central

    Kovács, Gábor; Prazsák, István; Eichardt, János; Vári, Gábor; Gyurkovics, Henrik

    2015-01-01

    Abstract According to the most recent taxonomic literature, three species of the genus Eresus are known in Central Europe, Eresus kollari, Eresus sandaliatus and Eresus moravicus. We recognized a fourth distinctive species from Hungary, which is described as Eresus hermani sp. n. Eresus hermani has an early spring copulation period, females have a light grey (grizzled) cephalothorax due to a heavy cover of lightly colored setae, and an epigyne with large flat areas posterior to the epigynal pit, while males are distinguished by a broad and blunt terminal tooth of the conductor. An updated and modified comparative table of ?ezá? et al. (2008) to include all four Central European Eresus species, and a simple key to the species group’s species are given. Habitus, epigyne, vulva and conductor of Eresus kollari, Eresus moravicus and Eresus sandaliatus are also illustrated. An annotated list of papers illustrating Eresus hermani due to misidentifications is presented. PMID:25901112

  20. Litomosoides (Nemata: Filarioidea) of bats from Bolivia with records for three known species and the description of a new species.

    PubMed

    Notarnicola, Juliana; Ruíz, F Agustín Jiménez; Gardner, Scott L

    2010-08-01

    Herein, we describe Litomosoides salazari n. sp. collected from the body cavity of the yellow bat, Lasiurus ega , from Bolivia. This new species of filarioid nematode is most closely related to the carinii group and is characterized by its relatively small size with the vulva located slightly posterior to the esophago-intestinal junction; an arrow-shaped buccal capsule; and a short, rounded tail. New host and locality records for both Litomosoides hamletti and L. chandleri in phyllostomid bats, and L. brasiliensis occurring in both phyllostomid and vespertilionid bats, are provided. The morphological variability of the specimens is documented by providing comparative measurements of 3 known species. Litomosoides brasiliensis occurs in 6 species of bats from Bolivia and was the most common species of filarioid nematode encountered. All 4 species of nematodes, including the new species, were found in sympatry at Chijchijpa, a locality in the Yungas of Bolivia. PMID:20738202

  1. A new species of Syphacia (Seuratoxyuris) (Nematoda: Oxyuridae) from Sooretamys angouya Fischer, 1814 (Rodentia: Cricetidae) in Argentina.

    PubMed

    Robles, María del Rosario; Panisse, Guillermo; Navone, Graciela Teresa

    2014-11-01

    Syphacia (Seuratoxyuris) hugoti n. sp. (Nematoda: Oxyuridae) is described from the cecum of Sooretamys angouya (Cricetidae: Sigmodontinae: Oryzomyini) captured in Formosa Province, Argentina. The diagnosis of the subgenus is emended, and the new species is separated from eight congeners by the distribution of submedian papillae and amphids, shape of the cephalic plate, presence of deirids, absence of cervical and lateral alae, length of the spicule, structure of the accessory hook of the gubernaculum and distance of excretory pore and vulva from the anterior extremity. The analysis suggests that S. (Se.) oryzomyos should be removed from Seuratoxyuris and redesignated as S. (Syphacia) oryzomyos n. comb. To date, of the species of Syphacia found in South and North American, 7 parasitize Oryzomyini rodents, of which two are distributed in Argentina. The present study constitutes the first record of the subgenus Seuratoxyuris from Argentina and the third record of a Syphacia species from rodents of the tribe Oryzomyini. PMID:24995650

  2. Becker's Nevus Syndrome.

    PubMed

    Dasegowda, Sathyanarayana B; Basavaraj, Gb; Nischal, Kc; Swaroop, Mr; Umashankar, Np; Swamy, Suchetha S

    2014-07-01

    Becker's nevus is a cutaneous hamartoma characterized by circumscribed hyperpigmentation with hypertrichosis. Becker's nevus syndrome is an association of Becker's nevus with unilateral breast hypoplasia and muscle, skin, and/or skeletal abnormalities. We here report a case of a 15 year-old female who presented with bilateral Becker's nevus over her groins, thighs, vulva, and in front of the neck from the age of 5 years. She had associated mental retardation, delayed development of mile stones, delayed puberty, dwarfism, depressed nasal bridge, long slender digits, crowding of lateral toes, valgus deformity of first metatarsophalangeal joint, mitral valve prolapse, muddy conjunctiva with hypertrophic and hyperpigmented caruncle of both eyes, ichthyosis, brownish hair, and absence of axillary and pubic hair. On histopathological examination collagen hamartoma underneath the Becker's nevus was found. PMID:25071279

  3. Anatomy of the clitoris and the female sexual response.

    PubMed

    Pauls, Rachel N

    2015-04-01

    The clitoris may be the most pivotal structure for female sexual pleasure. While its significance has been reported for hundreds of years, no complete anatomical description was available until recently. Most of the components of the clitoris are buried under the skin and connective tissues of the vulva. It comprises an external glans and hood, and an internal body, root, crura, and bulbs; its overall size is 9-11 cm. Clitoral somatic innervation is via the dorsal nerve of the clitoris, a branch of the pudendal nerve, while other neuronal networks within the structure are complex. The clitoris is the center for orgasmic response and is embryologically homologous to the male penis. While the source of vaginal eroticism might or might not be exclusively clitoral stimulation, it is necessary to understand the intricate anatomy of the organ to assess the data in this regard. Ultimately, sexual enjoyment entails a balance of physical and emotional factors and should be encouraged. PMID:25727497

  4. EMT-Inducing Molecular Factors in Gynecological Cancers

    PubMed Central

    Campo, Loredana; Zhang, Catherine; Breuer, Eun-Kyoung

    2015-01-01

    Gynecologic cancers are the unregulated growth of neoplastic cells that arise in the cervix, ovaries, fallopian tubes, uterus, vagina, and vulva. Although gynecologic cancers are characterized by different signs and symptoms, studies have shown that they share common risk factors, such as smoking, obesity, age, exposure to certain chemicals, infection with human immunodeficiency virus (HIV), and infection with human papilloma virus (HPV). Despite recent advancements in the preventative, diagnostic, and therapeutic interventions for gynecologic cancers, many patients still die as a result of metastasis and recurrence. Since mounting evidence indicates that the epithelial-mesenchymal transition (EMT) process plays an essential role in metastatic relapse of cancer, understanding the molecular aberrations responsible for the EMT and its underlying signaling should be given high priority in order to reduce cancer morbidity and mortality. PMID:26356073

  5. Genitourinary syndrome of the menopause--dawn of a new era?

    PubMed

    Panay, N

    2015-10-01

    Many millions of postmenopausal women continue to suffer in silence from symptoms resulting from estrogen-deficient atrophy of the vulva, vagina and urinary tract whilst the medical profession continues to debate what the condition should be called, how it should be assessed and whether it should be universally treated. It is high time that a unified approach was adopted by all medical societies to reach a consensus on definitions, recognition and management. With the development of the nomenclature for genitourinary syndrome of the menopause (GSM), advances in GSM assessment tools and quality-of-life questionnaires and novel therapeutic interventions, the signs are positive that a new era is finally dawning. PMID:26366795

  6. Vulvar extrauterine endometrial stromal sarcoma: A case report and literature review.

    PubMed

    Zaza, Khaled J; Arafah, Maria A; Al-Badawi, Ismail A

    2015-09-01

    Endometrial stromal sarcoma (ESS) is an extremely rare neoplasm accounting for only 0.2% of all uterine malignancies and for 15-26% of primary uterine sarcomas. The annual incidence of ESS is 1-2 per million women. Herein, to the best of our knowledge, we present the first reported case of ESS of the vulva in a 50-year-old female presenting with per vaginal spotting over a period of three months. Her past surgical history included a subtotal hysterectomy and left salpingo-oophorectomy for uterine fibroids ten years previously. On examination, a 3.5×3×2 cm cystic mass was found in the right labia majora. The mass was excised and the diagnosis of endometrial stromal sarcoma was made. Subsequent metastatic workup was negative and the patient was started on megestrol acetate. She has remained disease free with no signs or symptoms of recurrent or advanced disease for 28 months. PMID:25585306

  7. Treatment of the genitourinary syndrome of menopause.

    PubMed

    Palacios, S; Mejía, A; Neyro, J L

    2015-10-01

    The vagina, vulva, vestibule, labia majora/minora, and bladder trigone have a high concentration of estrogen receptors; therefore, they are a sensitive biological indicator of serum levels of these hormones in women. The estrogen loss in postmenopausal women produces a dysfunction called genitourinary syndrome of menopause. The principal therapeutic goal in the genitourinary syndrome of menopause is to relieve symptoms. Treatment options, as well as local and systemic hormonal treatment are changes in lifestyle and non-hormonal treatments mainly based on the use of moisturizers and lubricants. New treatments that have recently appeared are ospemifeme, the first selective hormone receptor modulator for dyspareunia and vulvovaginal atrophy treatment, and the use of vaginal laser. This review has been written with the intention of giving recommendations on the prevention and treatment of genitourinary syndrome of menopause. PMID:26366797

  8. The urogenital system and the menopause.

    PubMed

    Calleja-Agius, J; Brincat, M P

    2015-10-01

    The major cause of urogenital atrophy in menopausal women is estrogen loss. The symptoms are usually progressive in nature and deteriorate with time from the menopausal transition. The most prevalent urogenital symptoms are vaginal dryness, vaginal irritation and itching. The genitourinary syndrome of menopause includes vulvovaginal atrophy and the postmenopausal modifications of the lower urinary tract. Dyspareunia and vaginal bleeding from fragile atrophic skin are common problems. Other urogenital complaints include frequency, nocturia, urgency, stress urinary incontinence and urinary tract infections. Atrophic changes of the vulva, vagina and lower urinary tract can have a large impact on the quality of life of the menopausal woman. However, hormonal and non-hormonal treatments can provide patients with the solution to regain the previous level of function. Therefore, clinicians should sensitively question and examine menopausal women, in order to correctly identify the pattern of changes in urogenital atrophy and manage them appropriately. PMID:26366796

  9. 'Vulval oedema': a conundrum!

    PubMed

    Afshan, Nida; Gokhale, Leena

    2015-01-01

    Massive oedema of the vulva appears to be a sequel of an underlying systemic disease in pregnant women. Isolated vulval oedema in pregnancy is rare. Vulval oedema has been treated, depending on pathophysiology, with steroids, furosemide, albumin and continuous epidural analgaesia. We present a case of vulval oedema, where the oedema was confined to the labia minora in a healthy young pregnant woman. The patient was in pain and extreme discomfort due to the labial swelling, and caesarean section was being considered for delivery as the massive oedema would obstruct the birth canal. The swelling, however, resolved successfully by simple drainage. In the literature, there have been cases delivered by caesarean section as vulval swelling was causing an obstruction. PMID:26538126

  10. Unusual presence of Ornidia robusta (Diptera: Syrphidae) causing pig myiasis in Argentina.

    PubMed

    López Millán, Cyntia; Olea, María S; Dantur Juri, María J

    2015-12-01

    Myiasis is caused by dipterous larvae from the Calliphoridae, Sarcophagidae, Muscidae, Cuterebridae, and Syrphidae families. In this work, Cochliomyia hominivorax, Chrysomya megacephala, and Ornidia robusta were identified causing vulva, ear, and leg myiasis in pigs in Tucuman province, northwestern Argentina. The report of the presence of C. hominivorax and C. megacephala is very important due to their role as myiasis-causing and disease vectors. The occurrence of Ornidia robusta is remarkable, since it constitutes the first record of myiasis in general and of myiasis in pigs in particular. Lastly, the presence of Sarcophaga spp. is also interesting, since some of them originate myiasis and are therefore of concern for cattle, wild animals, and human populations. PMID:26450595

  11. Photodynamic therapy in patients with recurrent gynecological carcinomas

    NASA Astrophysics Data System (ADS)

    Hetzel, Heinz; Mueller, Elisabeth; Kostron, Herwig

    1993-03-01

    Patients with recurrent gynecological carcinomas have a poor prognosis with a median survival time of 3 - 6 months. Four patients with recurrent vulva carcinomas, one patient with a recurrent breast cancer, and one with a recurrent cervical carcinoma underwent PDT after parenteral or topical sensitization with Photosan 3. Of those patients two women made a complete recovery with no evidence of disease 27 and 24 months after. One patient responded partially with two recurrences which were retreated twice after topical sensitization, she has survived 16 months. The remaining patients showed partial response and died 3 and 8 months after PDT. The energy delivered by an argon-dye-laser ranged between 225 and 750 J/cm2. Photosan 3 was given intravenously at a dose of 2.5 mg/kg body weight and was tolerated without any allergic reaction. A response rate of nearly 50% in recurrent gynecological malignancies encourages us to pursue PDT in gynecological diseases.

  12. LASER BIOLOGY AND MEDICINE: Combined application of optical methods to increase the information content of optical coherent tomography in diagnostics of neoplastic processes

    NASA Astrophysics Data System (ADS)

    Kuranov, R. V.; Sapozhnikova, V. V.; Shakhova, N. M.; Gelikonov, V. M.; Zagainova, E. V.; Petrova, S. A.

    2002-11-01

    A combined application of optical methods [optical coherent tomography (OCT), cross-polarisation optical coherent tomography, and fluorescence spectroscopy] is proposed for obtaining information on morphological and biochemical changes occurring in tissues in norm and pathology. It is shown that neoplastic and scar changes in esophagus can be distinguished using a combination of polarisation and standard OCT due to the difference between the depolarising properties of the tissues caused by the structural properties of collagenic fibres in stroma. It is shown that OCT combined with fluorescence spectroscopy with the use of 5-aminolevulinic acid is promising for determining the boundaries of carcinoma of the uterine cervix and vulva. It is found that the tumour boundary detected by optical methods coincides with the morphological boundary and extends beyond colposcopically determined boundary by about 2 mm.

  13. Round Ligament of Uterus Leiomyoma: An Unusual Cause of Dyspareunia

    PubMed Central

    Birge, Ozer; Arslan, Deniz; Kinali, Erdinc; Bulut, Berk

    2015-01-01

    Round ligament of uterus leiomyoma is a rare, benign tumor of the vulva. Its incidence is not known exactly, and the mean age ranges from 13 to 70. Although clinical properties of benign and malignant diseases in the vulvar area are frequently similar, early diagnosis and treatment are essential. Local excision is recommended as definitive therapy. We present an 28-year-old female without any birth with a mass in anterior vaginal wall diagnosed as vulvar leiomyoma. In conclusion, a brief review of relevant literature emphasizes that leiomyomas are quite rare outside of the uterus but they might occur in any tissue or organ containing smooth muscle, spontaneously or parasitically after the spreading effect of an accident or surgical trauma. Clinicians should be alert especially for the diagnosis in a tissue with smooth muscle content. PMID:25834749

  14. X monosomy in a virilized female cat.

    PubMed

    Szczerbal, I; Nizanski, W; Dzimira, S; Nowacka-Woszuk, J; Ochota, M; Switonski, M

    2015-04-01

    An infertile Siamese female cat was subjected for clinical, histological, cytogenetic and molecular studies due to ambiguous external genitalia (vulva, vagina, rudimentary penis and scrotum-like structure) and masculine behaviour. An elevated oestrogen activity and a detectable level of testosterone were found. The cat underwent laparotomy. The gonads and the uterus were removed and subjected for histological studies, which showed ovaries with corpora lutea and a some primordial follicles. Chromosome studies of lymphocyte and fibroblast cultures, with the use of Giemsa staining, G-banding and whole X chromosome painting by fluorescence in situ hybridization, revealed pure X monosomy. Molecular analysis showed the absence of the SRY gene. Our study revealed for the first time that X monosomy in cats may be associated with virilization, in spite of the lack of the SRY gene. PMID:25611903

  15. Morphological and molecular characterization of Pratylenchus lentis n. sp. (Nematoda: Pratylenchidae) from Sicily

    PubMed Central

    De Luca, F.; Handoo, Z. A.; Di Vito, M.

    2008-01-01

    Pratylenchus lentis n. sp. parasitizing roots of lentil in Sicily, Italy, is described and illustrated. The new species is characterized by a relatively high lip region with three annuli, mean stylet length of 16 ?m, with anteriorly flattened knobs, cylindrical body with a relatively anterior vulva, large and ovoid spermatheca full of sperm, plump tail with truncate, irregularly annulated terminus, and by the presence of males. Molecular ITS-RFLP and sequencing analyses of the new species showed clear differences from other most morphologically similar species, such as P. thornei and P. mediterraneus. Preliminary host range tests revealed that chickpea, pea, faba bean and durum wheat are good hosts of P. lentis n. sp., whereas common bean, alfalfa and barley are less robust hosts and tomato, bell pepper, eggplant, melon and sunflower are poor hosts for the nematode. PMID:19440258

  16. Late injury of cancer therapy on the female reproductive tract

    SciTech Connect

    Grigsby, P.W.; Russell, A.; Bruner, D.

    1995-03-30

    The purpose of this article is to review the late effects of cancer therapy on the female reproductive tract. The anatomic sites detailed are the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The available pathophysiology is discussed. Clinical syndromes are presented. Tolerance doses of irradiation for late effects are rarely presented in the literature and are reviewed where available. Management strategies for surgical, radiotherapeutic, and chemotherapeutic late effects are discussed. Endpoints for evaluation of therapeutic late effects have been formulated utilizing the symptons, objective, management, and analytic (SOMA) format. Late effects on the female reproductive tract from cancer therapy should be recognized and managed appropriately. A grading system for these effects is presented. Endpoints for late effects and tolls for the evaluation need to be further developed. 61 refs., 9 figs., 13 tabs.

  17. Lesions and Neoplasms of the Penis: A Review.

    PubMed

    Heller, Debra S

    2016-01-01

    In addition to practitioners who care for male patients, with the increased use of high-resolution anoscopy, practitioners who care for women are seeing more men in their practices as well. Some diseases affecting the penis can impact on their sexual partners. Many of the lesions and neoplasms of the penis occur on the vulva as well. In addition, there are common and rare lesions unique to the penis. A review of the scope of penile lesions and neoplasms that may present in a primary care setting is presented to assist in developing a differential diagnosis if such a patient is encountered, as well as for practitioners who care for their sexual partners. A familiarity will assist with recognition, as well as when consultation is needed. PMID:26579840

  18. Rhabdochona kharani sp. n. (Nematoda: Rhabdochonidae) from the fish Labeo gedrosicus Zugmayer, 1912 from Garruk, District Kharan, Balochistan, Pakistan.

    PubMed

    Asmatullah, Kakar; Bilqees, Fatima Mujib; Kakar, Juma Khan

    2006-01-01

    A new nematode species, Rhabdochona kharani sp. nov., has been isolated from the intestine, stomach and swim bladder of the fish Labeo gedrosicus Zugmayer, 1912 (Fam. Cyprinidae: Cypriniformes) from spring water at Garruk, District Kharan, Balochistan. The new species is characterized largely by the presence of eight anterior teeth in the prostom, inconspicuous deirids, by the shape and length of unequal spicules (0.08 - 0.09 and 2.9 - 3.1 mm), and by 17-18 pairs of caudal papillae including 6-7 postanal, one adanal, and 10 -11 preanal. Other characteristics include a pointed tail tip, non filamented eggs, a bulbous, voluminous, vaginal complex that is directed backward, and a vulva that is post-equatorial with a triangular large anterior lip and a smaller posterior lip. PMID:17106860

  19. First description of the horse stomach worm, Habronema muscae (Spirurida: Habronematidae) by scanning electron microscopy.

    PubMed

    Naem, Soraya

    2007-07-01

    Habronema muscae (Spirurida: Habronematidae) occurs in the stomach of equids, is transmitted by adult muscid dipterans and causes gastric habronemiasis. Scanning electron microscopy (SEM) was used to study the morphological aspects of adult worms of this nematode in detail. The worms possess two trilobed lateral lips. The buccal cavity was cylindrical, with thick walls and without teeth. Around the mouth, four submedian cephalic papillae and two amphids were seen. A pair of lateral cervical papillae was present. There was a single lateral ala and in the female the vulva was situated in the middle of the body. In the male, there were wide caudal alae, and the spicules were unequal and dissimilar. At the posterior end of the male, four pairs of stalked precloacal papillae, unpaired post-cloacal papillae and a cluster of small papillae were present. In one case, the anterior end showed abnormal features. PMID:17318578

  20. Neoascarophis macrouri n. sp. (Nematoda: Cystidicolidae) from the stomach of Macrourus berglax (Macrouridae) in the eastern Greenland Sea.

    PubMed

    Moravec, Frantisek; Klimpel, Sven; Kara, Esra

    2006-03-01

    A new species of parasitic nematode, Neoascarophis macrouri n. sp. (Cystidicolidae), is described from the stomach and stomach wall of the marine deep-water fish Macrourus berglax (onion-eye grenadier) in the eastern Greenland Sea (North Atlantic Ocean). The new species, studied using both light and scanning electron microscopy, is characterised mainly by the location of the vulva near the posterior end of the body (a short distance anterior to the anus), non-filamented eggs, the structure of the mouth, a short vestibule and the length of the spicules (567-615 and 144-156 mum). Metabronema insulanum Solov'eva, 1991 is transferred to Neoascarophis as N. insulana (Solov'eva, 1991) n. comb. PMID:16612659

  1. A new species of Neoascarophis (Nematoda: Cystidicolidae) parasitic in Macrourus carinatus (Macrouridae) from Argentinean waters.

    PubMed

    Rossin, María A; Incorvaia, Inés S; Timi, Juan T

    2012-06-01

    Nematodes of the cystidicolid Neoascarophis Machida, 1976 , are all parasites of macrourid fishes, making up at present 5 species. Several other unidentified species have also been reported in several fish species from the northern and southern Atlantic Ocean, including 1 from Macrourus carinatus (Günther) (Macrouridae) in the southwest Atlantic Ocean. During a parasitological survey carried out on samples of M. carinatus from Patagonian waters, nematodes referable to Neascarophis were found in ulcers in the gastric mucosa. These nematodes Neascarophis sphaerocaudata n. sp. closely resemble N. macrouri by the posterior position of the vulva and the dilated posterior extremity in females. However, the new species differs from N. macrouri mainly by its larger size, a larger muscular esophagus, and a widely globose posterior extremity in females. SEM study of cephalic structures also showed morphological differences between both species, especially in the morphology of the submedian labia and lateral pseudolabia. In view of these differences a new species is proposed. PMID:22746395

  2. A Forward Genetic Screen for Suppressors of Somatic P Granules in Caenorhabditis elegans.

    PubMed

    Kelly, Ashley L; Senter-Zapata, Michael J; Campbell, Anne C; Lust, Hannah E; Theriault, Monique E; Andralojc, Karolina M; Updike, Dustin L

    2015-01-01

    In Caenorhabditis elegans, germline expression programs are actively repressed in somatic tissue by components of the synMuv (synthetic multi-vulva) B chromatin remodeling complex, which include homologs of tumor suppressors Retinoblastoma (Rb/LIN-35) and Malignant Brain Tumor (MBT/LIN-61). However, the full scope of pathways that suppress germline expression in the soma is unknown. To address this, we performed a mutagenesis and screened for somatic expression of GFP-tagged PGL-1, a core P-granule nucleating protein. Eight alleles were isolated from 4000 haploid genomes. Five of these alleles exhibit a synMuv phenotype, whereas the remaining three were identified as hypomorphic alleles of known synMuv B genes, lin-13 and dpl-1. These findings suggest that most suppressors of germline programs in the soma of C. elegans are either required for viability or function through synMuv B chromatin regulation. PMID:26100681

  3. Estrus-related odors in body fluids of dairy cows.

    PubMed

    Kiddy, C A; Mitchell, D S; Hawk, H W

    1984-02-01

    Six experiments were to test for estrus-associated odors in 1) swabs of the vulva and vestibule, 2) fluids from deep in the vagina, 3) naturally voided urine, 4) urine obtained from the bladder by catheter, 5) milk, and 6) blood plasma. Tests were with dogs trained to identify vaginal fluids from estrous cows. In the tests, dogs were walked along lines of seven sample bottles consisting of samples from two estrous cows, two luteal-phase cows, one vaginal swab from estrous cows used as a standard, and two blank sample bottles. Correct responses to fluids from estrous cows averaged 97, 86, 96, 97, 99, and 94% for the six fluids listed. Incorrect responses to fluids from luteal-phase cows were 2, 1, 1, 1, 1, and 8%. Responses to blank samples were usually zero. Results indicate that odors associated with estrus are spread throughout the cow's body fluid. PMID:6715632

  4. A new species of Neoascarophis (Nematoda: Cystidicolidae) parasitic in Mullus argentinae (Perciformes: Mullidae) from the Atlantic coast of South America.

    PubMed

    Pereira, Aldenice N; Timi, Juan T; Vieira, Fabiano M; Luque, José L

    2012-02-01

    A new nematode species (Neoascarophis mariae n. sp.) is described based on specimens collected from the Argentine goatfish Mullus argentinae (Hubbs et Marini) from coastal waters off the state of Rio de Janeiro, Brazil. In the genus, the new species belongs to the group of species with females that have the vulva near the posterior end of the body. Only males of Neoascarophis longispicula Moravec et Klimpel, 2009 are known and can be distinguished from those of the new species by their larger body, developed and somewhat dorsoventrally expanded flat inner part of the pseudolabia, bifurcate deirids and larger spicules (the left one with a rounded tip) with a different length ratio. Other species with females that have the vulva near the equatorial region are N. yarihige Machida, 1976 and N. bathygadi Machida, 1976. Both males and females of N. yarihige are longer than those of the new species and have a shorter vestibule; males have shorter spicules with a different length ratio. Neoascarophis bathygadi is the only member of the genus that shares the presence of a cephalic vesicle with the new species, which, however, is shorter and arises at 40 microm from the anterior end instead from the deirids, as in the new species. Both males and females of N. bathygadi are also longer than those of the new species and have a shorter vestibule; males have a larger left spicule, but shorter right spicule and a different length ratio. Ascarophis upeneichthys Johnston et Mawson, 1945, a parasite ofa mullid host, is transferred to Neoascarophis Machida, 1976 and is distinguished from the new species by having a shorter vestibule in females and shorter spicules (left spicule with a pointed tip) with a different length ratio in males. PMID:22439430

  5. Biological risks associated with consumption of reptile products.

    PubMed

    Magnino, Simone; Colin, Pierre; Dei-Cas, Eduardo; Madsen, Mogens; McLauchlin, Jim; Nöckler, Karsten; Maradona, Miguel Prieto; Tsigarida, Eirini; Vanopdenbosch, Emmanuel; Van Peteghem, Carlos

    2009-09-15

    The consumption of a wide variety of species of reptiles caught from the wild has been an important source of protein for humans world-wide for millennia. Terrapins, snakes, lizards, crocodiles and iguanas are now farmed and the consumption and trade of their meat and other edible products have recently increased in some areas of the world. Biological risks associated with the consumption of products from both farmed and wild reptile meat and eggs include infections caused by bacteria (Salmonella spp., Vibrio spp.), parasites (Spirometra, Trichinella, Gnathostoma, pentastomids), as well as intoxications by biotoxins. For crocodiles, Salmonella spp. constitute a significant public health risk due to the high intestinal carrier rate which is reflected in an equally high contamination rate in their fresh and frozen meat. There is a lack of information about the presence of Salmonella spp. in meat from other edible reptilians, though captive reptiles used as pets (lizards or turtles) are frequently carriers of these bacteria in Europe. Parasitic protozoa in reptiles represent a negligible risk for public health compared to parasitic metazoans, of which trichinellosis, pentastomiasis, gnathostomiasis and sparganosis can be acquired through consumption of contaminated crocodile, monitor lizard, turtle and snake meat, respectively. Other reptiles, although found to harbour the above parasites, have not been implicated with their transmission to humans. Freezing treatment inactivates Spirometra and Trichinella in crocodile meat, while the effectiveness of freezing of other reptilian meat is unknown. Biotoxins that accumulate in the flesh of sea turtles may cause chelonitoxism, a type of food poisoning with a high mortality rate in humans. Infections by fungi, including yeasts, and viruses widely occur in reptiles but have not been linked to a human health risk through the contamination of their meat. Currently there are no indications that natural transmissible spongiform encephalopathies (TSEs) occur in reptilians. The feeding of farmed reptiles with non-processed and recycled animal products is likely to increase the occurrence of biological hazards in reptile meat. Application of GHP, GMP and HACCP procedures, respectively at farm and slaughterhouse level, is crucial for controlling the hazards. PMID:19679367

  6. Genotype-phenotype Correlation of the p.R1165C Mutation in the MYH9 Disorder: Report of a Japanese Pedigree.

    PubMed

    Okano, Satomi; Takase, Masashi; Iseki, Kenichi; Toriumi, Naohisa; Kaneda, Makoto; Kunishima, Shinji

    2015-08-01

    MYH9 disorder is a rare autosomal dominant disease characterized by congenital thrombocytopenia with giant platelets and leukocyte inclusion bodies and is often associated with Alport-like symptoms, such as glomerulonephritis, sensorineural hearing loss, and cataracts. We report a Japanese pedigree wherein the MYH9 p.R1165C mutation was present in over 4 generations. Three individuals were misdiagnosed as Bernard-Soulier syndrome carriers. Among the 12 patients with abnormal hematological features, the proband's mother, aunt, and grandaunt presented with sensorineural hearing impairment, and the mother presented with presenile cataract, and nephritis. This case report confirms the previously established genotype-phenotype correlations of the MYH9 disorder that p.R1165C is associated with variable expression of nonhematological manifestations. Careful detection of leukocyte inclusion bodies in peripheral blood smears is necessary to prevent misdiagnosis. PMID:26056797

  7. Long-term video EEG monitoring for diagnosis of psychogenic nonepileptic seizures

    PubMed Central

    Gedzelman, Evan R; LaRoche, Suzette M

    2014-01-01

    Psychogenic nonepileptic seizures have long been known by many names. A short list includes hysteroepilepsy, hysterical seizures, pseudoseizures, nonepileptic events, nonepileptic spells, nonepileptic seizures, and psychogenic nonepileptic attacks. These events are typically misdiagnosed for years and are frequently treated as electrographic seizures and epilepsy. These patients experience all the side effects of antiepileptic drugs and none of the benefits. Video electroencephalogram (EEG) monitoring is the gold standard diagnostic test that can make a clear distinction between psychogenic nonepileptic seizures and epilepsy. Video EEG allows us to correctly characterize the patient’s events and therefore properly diagnose and direct management. As a result, years of faulty management and wasted health care dollars can be avoided. PMID:25342907

  8. CLOVE Syndrome (Congenital Lipomatous Overgrowth, Vascular Malformations, and Epidermal Nevi): CNS Malformations and Seizures may be a Component of this Disorder

    PubMed Central

    Gucev, Zoran S.; Tasic, Velibor; Jancevska, Aleksandra; Konstantinova, Marina Krstevska; Pop-Jordanova, Nada; Trajkovski, Zoran; Biesecker, Leslie G.

    2010-01-01

    A newborn girl was found to have a massive lymphatic truncal vascular malformation with overlying cutaneous venous anomaly associated with overgrown feet and splayed toes. These manifestations comprise the recently described CLOVE syndrome. She also had cranial asymmetry and developed generalized seizures, which were treated with anticonvulsants. Cranial CT showed encephalomalacia, widening of the ventricles and the sulci, hemimegalencephaly (predominantly white matter) and partial agenesis of corpus callosum. Review of the literature identified several other patients with CLOVE syndrome, some of whom were misdiagnosed as having Proteus syndrome, with strikingly similar manifestations. We conclude that CNS manifestations including hemimegalencephaly, dysgenesis of the corpus callosum, neuronal migration defects, and the consequent seizures, may be a more common manifestation of CLOVE syndrome than is presently appreciated. PMID:18816642

  9. Adult-onset Idiopathic Focal Lower Extremity Dystonia: A Rare Task-Specific Dystonia

    PubMed Central

    Ramdhani, Ritesh A.; Frucht, Steven J.

    2013-01-01

    Background Adult-onset focal lower extremity (LE) dystonia is rare, but there have recently been a number of case series that have reported an idiopathic variant triggered during ambulation. Methods We describe nine patients with idiopathic, focal task-specific LE dystonia. We conducted a comparative analysis that included our cohort and several recently published case series to further characterize the disorder. Results A total of 48 patients (37 female, 11 male) were compared. The average age of onset was 48 years; 36 patients had distal extremity involvement (75%), 5 proximal (10%), and 7 both proximal and distal (15%). Among 33 patients in which the dystonic side was known, 20 were affected on the left (61%). Inversion of the foot with flexion of one or more toes was the most prevalent pattern in those with distal extremity involvement. Discussion This is a novel task-specific dystonia triggered during ambulation that is often misdiagnosed as an orthopedic or psychogenic issue. PMID:23450825

  10. A novel deletion/insertion caused by a replication error in the ?-globin gene locus control region.

    PubMed

    Joly, Philippe; Lacan, Philippe; Garcia, Caroline; Meley, Roland; Pondarré, Corinne; Francina, Alain

    2011-01-01

    Deletions in the ?-globin locus control region (?-LCR) lead to (????)(0)-thalassemia [(????)(0)-thal]. In patients suffering from these rare deletions, a normal hemoglobin (Hb), phenotype is found, contrasting with a hematological thalassemic phenotype. Multiplex-ligation probe amplification (MLPA) is an efficient tool to detect ?-LCR deletions combined with long-range polymerase chain reaction (PCR) and DNA sequencing to pinpoint deletion breakpoints. We present here a novel 11,155 bp ?-LCR deletion found in a French Caucasian patient which removes DNase I hypersensitive site 2 (HS2) to HS4 of the ?-LCR. Interestingly, a 197 bp insertion of two inverted sequences issued from the HS2-HS3 inter-region is present and suggests a complex rearrangement during replication. Carriers of this type of thalassemia can be misdiagnosed as an ?-thal trait. Consequently, a complete ?- and ?-globin gene cluster analysis is required to prevent a potentially damaging misdiagnosis in genetic counselling. PMID:21797698

  11. Phenomenology of Borderline Personality Disorder

    PubMed Central

    De Genna, Natacha M.; Feske, Ulrike

    2015-01-01

    Little is known about racial differences in borderline personality disorder (BPD) that may influence etiology, phenomenology, and treatment of women with BPD. A total of 83 women with BPD participated in this cross-sectional study: n = 41 white and n = 42 African-American women. Structured interviews were used to assess Axis I and II disorders, and a series of interviews and questionnaires captured internalizing and externalizing symptoms. The white women with BPD reported more severe internalizing symptoms, whereas the African-American women reported more severe externalizing symptoms. Except for the association between race and number of suicide attempts, the relationship between race and internalizing/externalizing symptoms was mediated by socioeconomic status. In conclusion, African-American women with BPD may present with more severe symptoms of lack of anger control and fewer suicidal behaviors than those of white women with BPD, raising the possibility that they are misdiagnosed and receive treatments that are not optimal for BPD. PMID:24284636

  12. PAN's labyrinth: a multidisciplinary delayed diagnosis and patient's perspective.

    PubMed

    Barlow, Emma Louise; Seddon, Owen; Healy, Brendan

    2016-01-01

    Polyarteritis nodosa (PAN) is a rare, severe form of vasculitis affecting medium-sized vessels. It manifests as a multisystem syndrome, and may be associated with hepatitis B virus-associated PAN (HBV-PAN) although the incidence of this is declining with better vaccination strategies and awareness of bloodborne virus screening. We report a case in which a patient displayed many classical features of the disease, occurring separately over a period of months and leading to contact with various medical specialties. Managing each symptom in isolation led to a number of misdiagnoses (including testicular cancer) and the patient experienced considerable psychological stress and morbidity as a result. The case was complicated by acute pancreatitis developing after an initial treatment response. This may have been iatrogenic (as a consequence of either entecavir or steroids) or secondary to PAN. For our patient, this led to a protracted clinical course but eventual complete resolution of both pathologies. PMID:26733433

  13. Support of the Laboratory in the Diagnosis of Fungal Ocular Infections

    PubMed Central

    Vanzzini Zago, Virginia; Alcantara Castro, Marino; Naranjo Tackman, Ramon

    2012-01-01

    This is a retrospective, and descriptive study about the support that the laboratory of microbiology aids can provide in the diagnosis of ocular infections in patients whom were attended a tertiary-care hospital in México City in a 10-year-time period. We describe the microbiological diagnosis in palpebral mycose; in keratitis caused by Fusarium, Aspergillus, Candida, and melanized fungi; endophthalmitis; one Histoplasma scleritis and one mucormycosis. Nowadays, ocular fungal infections are more often diagnosed, because there is more clinical suspicion and there are easy laboratory confirmations. Correct diagnosis is important because an early medical treatment gives a better prognosis for visual acuity. In some cases, fungal infections are misdiagnosed and the antifungal treatment is delayed. PMID:22518339

  14. Sinonasal NUT-Midline Carcinoma - A Multimodality Approach to Diagnosis, Staging and Post-Surgical Restaging.

    PubMed

    Shaikh, Faiq; Pagedar, Nitin; Awan, Omer; McNeely, Parren

    2015-07-01

    Nuclear protein testis (NUT) midline carcinoma is a rare malignancy involving predominantly the midline structures of the body. It is characterized by its genotypic feature of BRD4-NUT translocation, which is in contrast with other malignant processes that are usually categorized based on their histologic/phenotypic features. As these tumors may vary in their histologic presentation, they can be misdiagnosed as poorly differentiated carcinomas. Moreover, they are often very aggressive and associated with high mortality. Therefore, it is extremely important to diagnose them early using computed tomography (CT) and magnetic resonance imaging (MRI) and perform staging and restaging using 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), in addition to accurately identifying them at a microscopic and molecular level. We report a unique case of a sinonasal NUT midline carcinoma that was diagnosed with CT, staged with PET/CT, and restaged using PET/CT and MRI. PMID:26244120

  15. Thyroid Paraganglioma.

    PubMed

    Lee, Sun Mi; Policarpio-Nicolas, Maria Luisa C

    2015-08-01

    Thyroid paragangliomas are rare tumors that arise from the inferior laryngeal paraganglia. Most patients are female and present with an asymptomatic thyroid nodule. Histologically, the tumor is composed of cells arranged in a well-defined nest (zellballen) pattern surrounded by a thin fibrovascular stroma. It is a diagnostic pitfall and is occasionally misdiagnosed as follicular neoplasm, medullary thyroid carcinoma, intrathyroid parathyroid proliferation, and especially secondary neuroendocrine tumors. Immunohistochemical stains (cytokeratin, parathyroid hormone, thyroid transcription factor 1, tyrosine hydroxylase, chromogranin A, synaptophysin, S100, calcitonin, carcinoembryonic antigen) are essential in establishing the diagnosis. Loss of succinate dehydrogenase complex, subunit B (SDHB), immunoexpression can be used to triage genetic testing because some mutations are associated with a higher risk for developing metastasis. Total thyroidectomy or lobectomy for solitary lesion is the preferred treatment. Elective lymph node dissection is usually not indicated. Postoperatively, patients should receive hormonal evaluation for functional disease and imaging for evaluation of multifocal or metastatic disease. PMID:26230601

  16. Rickettsia parkeri Rickettsiosis, Argentina

    PubMed Central

    Seijo, Alfredo C.; Crudo, Favio; Nicholson, William L.; Varela-Stokes, Andrea; Lash, R. Ryan; Paddock, Christopher D.

    2011-01-01

    Rickettsia parkeri, a recently identified cause of spotted fever rickettsiosis in the United States, has been found in Amblyomma triste ticks in several countries of South America, including Argentina, where it is believed to cause disease in humans. We describe the clinical and epidemiologic characteristics of 2 patients in Argentina with confirmed R. parkeri infection and 7 additional patients with suspected R. parkeri rickettsiosis identified at 1 hospital during 2004–2009. The frequency and character of clinical signs and symptoms among these 9 patients closely resembled those described for patients in the United States (presence of an inoculation eschar, maculopapular rash often associated with pustules or vesicles, infrequent gastrointestinal manifestations, and relatively benign clinical course). Many R. parkeri infections in South America are likely to be misdiagnosed as other infectious diseases, including Rocky Mountain spotted fever, dengue, or leptospirosis. PMID:21762568

  17. Paraneoplastic pemphigus in a burn intensive care unit: case report and review of the literature.

    PubMed

    Hayanga, Awori J; Lee, Timothy M; Pannucci, Christopher J; Knipp, Brian S; Olsen, Stephen H; Wang, Stewart C; Napolitano, Lena M

    2010-01-01

    Paraneoplastic pemphigus is a rare cause of acute diffuse blistering in the adult patient. It commonly presents with subepidermal blistering, epidermal necrosis, and symptoms of mucosal irritation, such as conjunctivitis and vaginal ulceration. Because of its rarity, it is frequently misdiagnosed as Stevens-Johnson syndrome or toxic epidermal necrolysis. In this study, the authors will describe clinical and histologic manifestations of paraneoplastic pemphigus. This case report describes a 45-year-old woman with paraneoplastic pemphigus who was admitted and treated in a burn intensive care unit. Although initially diagnosed with Stevens-Johnson syndrome, the patient had progression of desquamation when potentially offending medications were discontinued. Diffuse adenopathy was noted on examination, and biopsy confirmed a low-grade lymphoma. Paraneoplastic pemphigus is a rare but important cause of acute diffuse blistering in adults. This disorder should be considered in the differential diagnosis of patients with diffuse blistering. PMID:20683196

  18. Pleural epitheliod hemangioendothelioma: What started as a liver fluke and ended up being almost mistaken for malignant mesothelioma

    PubMed Central

    Jamy, Omer H.; Huber, Bryan; Giri, Smith

    2015-01-01

    Epitheliod hemangioendothelioma (EHE) is a rare tumor of vascular origin. The pleural variant has only been reported around 20 times in English literature. It commonly occurs in older men and carries a poor prognosis with average survival lasting from a few weeks to months. Pleural EHE (PEHE) can be a diagnostic challenge due to its rarity as well as similarities to other pleural and vascular tumors. There is currently no standard treatment for EHE. Due to the rarity of this disease, reaching a final diagnosis is challenging. It's clinical, radiological, and pathological resemblance to malignant mesothelioma can cause a delay in diagnosis. Special stains such as CD31, CD34, and factor VIII related antigen can help differentiate between the two. Ordering appropriate stains in a timely manner can help avoid misdiagnosing PEHE.

  19. Lipedema, a Rare Disease

    PubMed Central

    Shin, Bae Wook; Jeong, Ho Joong; Kim, Ghi Chan

    2011-01-01

    Lipedema is a chronic disease of lipid metabolism that results in the symmetrical impairment of fatty tissue distribution and storage combined with the hyperplasia of individual fat cells. Lipedema occurs almost exclusively in women and is usually associated with a family history and characteristic features. It can be diagnosed based on clinical history and physical examination. Lipedema is usually symmetrical, but spares the feet, is often painful to palpation, and is negative for Stemmer's sign. Additionally, lipedema patients can present with microangiopathies and lipomas. The well-known therapies for lipedema include complex decongestive therapy, pneumatic compression, and diet modifications. However, whether these treatments help reduce swelling is debatable. We encountered a case of lipedema that was initially misdiagnosed as lymphedema. The patient's clinical features and history were different from those typical of lymphedema, prompting a diagnosis of lipedema and she was treated with a complex decongestive therapy program. PMID:22506222

  20. Lipedema, a rare disease.

    PubMed

    Shin, Bae Wook; Sim, Young-Joo; Jeong, Ho Joong; Kim, Ghi Chan

    2011-12-01

    Lipedema is a chronic disease of lipid metabolism that results in the symmetrical impairment of fatty tissue distribution and storage combined with the hyperplasia of individual fat cells. Lipedema occurs almost exclusively in women and is usually associated with a family history and characteristic features. It can be diagnosed based on clinical history and physical examination. Lipedema is usually symmetrical, but spares the feet, is often painful to palpation, and is negative for Stemmer's sign. Additionally, lipedema patients can present with microangiopathies and lipomas. The well-known therapies for lipedema include complex decongestive therapy, pneumatic compression, and diet modifications. However, whether these treatments help reduce swelling is debatable. We encountered a case of lipedema that was initially misdiagnosed as lymphedema. The patient's clinical features and history were different from those typical of lymphedema, prompting a diagnosis of lipedema and she was treated with a complex decongestive therapy program. PMID:22506222

  1. Bed Bug Detection: Current Technologies and Future Directions

    PubMed Central

    Vaidyanathan, Rajeev; Feldlaufer, Mark F.

    2013-01-01

    Technologies to detect bed bugs have not kept pace with their global resurgence. Early detection is critical to prevent infestations from spreading. Detection based exclusively on bites is inadequate, because reactions to insect bites are non-specific and often misdiagnosed. Visual inspections are commonly used and depend on identifying live bugs, exuviae, or fecal droplets. Visual inspections are inexpensive, but they are time-consuming and unreliable when only a few bugs are present. Use of a dog to detect bed bugs is gaining in popularity, but it can be expensive, may unintentionally advertise a bed bug problem, and is not foolproof. Passive monitors mimic natural harborages; they are discreet and typically use an adhesive to trap bugs. Active monitors generate carbon dioxide, heat, a pheromone, or a combination to attract bed bugs to a trap. New technologies using DNA analysis, mass spectrometry, and electronic noses are innovative but impractical and expensive for widespread use. PMID:23553226

  2. Acute promyelocytic leukemia presenting as pulmonary thromboembolism: Not all APLs bleed

    PubMed Central

    Vaid, Ashok K; Batra, Sandeep; Karanth, Suman S; Gupta, Sachin

    2015-01-01

    We present a rare case of acute promyelocytic leukemia (APL) presenting as pulmonary thromboembolism being misdiagnosed as community-acquired pneumonia. Thrombotic phenomenon in APL are poorly understood and grossly underreported. In our case, following no response to standard antibiotic treatment, the patient was further investigated and detected to have an acute pulmonary thromboembolism following right lower limb deep vein thrombosis (DVT). Though, complete blood picture revealed only mild hyperleukocytosis, bone marrow biopsy and aspiration revealed 60% blasts and a positive t (15,17)(q22,12) and PML retinoic acid receptor alpha (RARA) fusion protein on molecular cytogenetics. He was diagnosed as APL and received treatment with all-transretinoic acid (ATRA) and arsenic trioxide (ATO) and therapeutic anticoagulation PMID:26629469

  3. Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder

    PubMed Central

    Gentile, Julie P.; Dillon, Kristy S.

    2013-01-01

    There is a wide variety of what have been called “dissociative disorders,” including dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Some of these diagnoses, particularly dissociative identity disorder, are controversial and have been questioned by many clinicians over the years. The disorders may be under-diagnosed or misdiagnosed, but many persons who have experienced trauma report “dissociative” symptoms. Prevalence of dissociative disorders is unknown, but current estimates are higher than previously thought. This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment plan. PMID:23556139

  4. Maturity-Onset Diabetes of the Young: What Do Clinicians Need to Know?

    PubMed Central

    2015-01-01

    Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes that is characterized by an early onset, autosomal dominant mode of inheritance and a primary defect in pancreatic ?-cell function. MODY represents less than 2% of all diabetes cases and is commonly misdiagnosed as type 1 or type 2 diabetes mellitus. At least 13 MODY subtypes with distinct genetic etiologies have been identified to date. A correct genetic diagnosis is important as it often leads to personalized treatment for those with diabetes and enables predictive genetic testing for their asymptomatic relatives. Next-generation sequencing may provide an efficient method for screening mutations in this form of diabetes as well as identifying new MODY genes. In this review, I discuss a current update on MODY in the literatures and cover the studies that have been performed in Korea. PMID:26706916

  5. Chronic candida endophthalmitis as a cause of intermediate uveitis.

    PubMed

    Amin, Rowayda Mohamed; Hamdy, Islam; Osman, Ihab Mohamed

    2015-01-01

    Intermediate uveitis is a subset of intraocular inflammation where vitritis is the most consistent sign, with or without snowball opacities or snow banks over the pars plana. Some patients will have an associated underlying systemic disease such as sarcoidosis, multiple sclerosis, ocular tuberculosis, inflammatory bowel disease, possibly Behçet's disease and intraocular lymphoma, whereas some will be classified as pars planitis in case of the lack of an identifiable systemic disease association. Our patient, a 47-year-old woman, developed intermediate uveitis after cataract surgery in her right eye, was misdiagnosed as pars planitis, and received steroid monotherapy for 8 months. Her inflammation only fully resolved after vitrectomy with removal of the intraocular lens (IOL) and capsular bag. Oral fluconazole and intravitreal amphotericin B injection had failed to resolve her inflammation when Candida albicans was identified as the cause of her persistent intermediate uveitis. PMID:25870216

  6. Lipedema: A Review of the Literature.

    PubMed

    Okhovat, Jean-Phillip; Alavi, Afsaneh

    2015-09-01

    Lipedema is a disorder of adipose tissue that primarily affects females and is often misdiagnosed as obesity or lymphedema. Relatively few studies have defined the precise pathogenesis, epidemiology, and management strategies for this disorder, yet the need to successfully identify this disorder as a unique entity has important implications for proper treatment. In this review, we sought to review and identify information in the existing literature with respect to the epidemiology, pathogenesis, clinical presentation, differential diagnosis, and management strategies for lipedema. The current literature suggests that lipedema appears to be a clinical entity thought to be related to both genetic factors and fat distribution. While distinct from lymphedema and obesity, there are some existing treatments such as complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. Management of lipedema is complex and distinct from lymphedema. The role of newer randomized controlled studies to further explore the management of this clinical entity remains promising. PMID:25326446

  7. Management of delayed posttraumatic cervical kyphosis.

    PubMed

    Lopez, Alejandro J; Scheer, Justin K; Abode-Iyamah, Kingsley; Smith, Zachary A; Hitchon, Patrick W; Dahdaleh, Nader S

    2016-01-01

    We describe three patients with misdiagnosed unstable fractures of the cervical spine, who were treated conservatively and developed kyphotic deformity, myelopathy, and radiculopathy. All three patients were then managed with closed reductions by crown halo traction, followed by instrumented fusions. Their neurologic function was regained without permanent disability in any patient. Unstable fractures of the cervical spine will progress to catastrophic neurologic injuries without surgical fixation. Posttraumatic kyphosis and the delayed reduction of partially healed fracture dislocations by preoperative traction are not well characterized in the subaxial cervical spine. The complete evaluation of any subaxial cervical spine fracture requires CT scanning to assess for bony fractures, and MRI to assess for ligamentous injury. This allows for assessment of the degree of instability and appropriate management. In patients with delayed posttraumatic cervical kyphosis, preoperative closed reduction provided adequate realignment, facilitating subsequent operative stabilization. PMID:26321304

  8. Late-diagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report.

    PubMed

    Enea, Davide; Busilacchi, Alberto; Cecconi, Stefano; Gigante, Antonio

    2013-07-01

    In this case report, we describe a large osteochondral fracture of the anterolateral femoral condyle in an adolescent athlete while dancing. At 3 months after the misdiagnosed injury, the condylar defect was covered by a layer of disorganized fibrous tissue rich in blood vessels. To achieve good repair, an accurate curettage of the fractured surfaces, a precise reduction, and a stable internal fixation of the fragments were performed. Two poly-L-lactic acid bioabsorbable screws were used to obtain appropriate compression. At the 2-year follow-up, the patient was asymptomatic and had resumed her previous dancing activity. An MRI scan showed no interruptions of the cartilage layer at the boundary with the healthy tissue, but cartilage thinning and extensive subchondral remodeling were detected. PMID:23511583

  9. Evidence of a major reservoir of non-malarial febrile diseases in malaria-endemic regions of Bangladesh.

    PubMed

    Swoboda, Paul; Fuehrer, Hans-Peter; Ley, Benedikt; Starzengruber, Peter; Ley-Thriemer, Kamala; Jung, Mariella; Matt, Julia; Fally, Markus A; Mueller, Milena K S; Reismann, Johannes A B; Haque, Rashidul; Khan, Wasif A; Noedl, Harald

    2014-02-01

    In malaria-endemic regions any febrile case is likely to be classified as malaria based on presumptive diagnosis largely caused by a lack of diagnostic resources. A district-wide prevalence study assessing etiologies of fever in 659 patients recruited in rural and semi-urban areas of Bandarban district in southeastern Bangladesh revealed high proportions of seropositivity for selected infectious diseases (leptospirosis, typhoid fever) potentially being misdiagnosed as malaria because of similarities in the clinical presentation. In an area with point prevalences of more than 40% for malaria among fever cases, even higher seroprevalence rates of leptospirosis and typhoid fever provide evidence of a major persistent reservoir of these pathogens. PMID:24420774

  10. Giant cell rich osteosarcoma of the mandible with abundant spindle cells and osteoclast-like giant cells mimicking malignancy in giant cell tumor

    PubMed Central

    Sun, Li-Mei; Zhang, Qing-Fu; Tang, Na; Mi, Xiao-Yi; Qiu, Xue-Shan

    2015-01-01

    Giant cell rich osteosarcoma is a relatively unusual histological form of osteosarcoma, common lesion usually presenting in the long bones of the appendicular skeleton. The occurrence in the mandible is exceptional rare. Histologically, this tumor tends to be a highly anaplastic, pleomorphic tumor in which the tumor cells may be: plasmacytoid, fusiform, ovoid, small round cells, clear cells, mono-or multinucleated giant cells, or, spindle cells. Herein, we present a case with the sternum and first thoracic vertebra metastasis from primary giant cell rich osteosarcoma of the mandible in a 28 year-old Chinese female. The tumor was predominantly composed of abundant spindle cells with marked atypia and numerous osteoclast-like giant cells reminiscent of malignancy in giant cell tumor. The unusual histological appearance can pose a great diagnostic challenge. It may be easily misdiagnosed, especially if the specimen is limited or from fine-needle aspiration. PMID:26464744

  11. Glutaric aciduria type 1 as a cause of dystonic cerebral palsy.

    PubMed

    Mohamed, Sarar; Hamad, Muddathir H; Hassan, Hamdy H; Salih, Mustafa A

    2015-11-01

    Glutaric aciduria type 1 (GA1) is an inherited inborn error of metabolism caused by a deficiency of the enzyme glutaryl Co-A dehydrogenase (GCDH). Here, we report a 14-month-old Saudi boy with GA1 who presented with severe dystonia and was mis-diagnosed as cerebral palsy (CP). He presented to our institute with encephalopathy following an episode of gastroenteritis. His physical examination showed dystonia and spastic quadriplegia. His investigations revealed elevated both urinary 3-hydroxy glutaric acid, and serum glutarylcarnitine. The DNA analysis confirmed homozygosity for a mutation in the GCDH-coding gene (c.482G greater than A; p.R161Q). This case alerts pediatricians to consider GA1 as a differential diagnosis of children presenting with dystonic CP. PMID:26593172

  12. Tulipalin A induced phytotoxicity.

    PubMed

    McCluskey, James; Bourgeois, Marie; Harbison, Raymond

    2014-04-01

    Tulipalin A induced phytotoxicity is a persistent allergic contact dermatitides documented in floral workers exposed to Alstroemeria and its cultivars.[1] The causative allergen is tulipalin A, a toxic glycoside named for the tulip bulbs from which it was first isolated.[2] The condition is characterized by fissured acropulpitis, often accompanied by hyperpigmentation, onychorrhexis, and paronychia. More of the volar surface may be affected in sensitized florists. Dermatitis and paronychia are extremely common conditions and diagnostic errors may occur. A thorough patient history, in conjunction with confirmatory patch testing with a bulb sliver and tuliposide A exposure, can prevent misdiagnosis. We report a case of Tulipalin A induced phytotoxicity misdiagnosed as an unresolved tinea manuum infection in a patient evaluated for occupational exposure. PMID:25024947

  13. T-cell-rich B-cell non-Hodgkin's lymphoma mimicking Hodgkin's disease.

    PubMed

    Bättig, B; Mueller-Garamvoelgyi, E; Cogliatti, S B; Schmid, U; Kappeler, A; Cerny, T; Laissue, J A; Fey, M F

    1999-04-01

    We report on a patient with recurrent T-cell-rich B-cell lymphoma (TCRBCL), initially misdiagnosed as a lymphocyte-rich Hodgkin's disease. This case exemplifies the diagnostic problems of TCRBCL and the need for immunophenotypic analysis to differentiate TCRBCL from Hodgkin's disease, nodular paragranuloma and peripheral T-cell lymphoma. A rather unusual aspect is the long disease-free interval between the excision of the node in and the late relapse in 1996. The significance of the abundant T-cell infiltration in this B-cell neoplasm will be discussed and the concepts concerning antitumor response will be reviewed. Based on epidemiological data and the clinical behaviour TCRBCL does not seem to represent a distinctive pathological entity. PMID:10221522

  14. Bordetella holmesii infection: current knowledge and a vision for future research.

    PubMed

    Pittet, Laure F; Posfay-Barbe, Klara M

    2015-08-01

    Bordetella holmesii is a recently recognized Gram-negative bacterium causing both pertussis-like respiratory symptoms and invasive infections, such as bacteremia, pneumonia, meningitis, arthritis, pericarditis and endocarditis. Few data are available on its epidemiological characteristics, mostly related to respiratory infections. However, these are frequently misdiagnosed as a Bordetella pertussis infection as most diagnostic tests routinely used are not species-specific, thus biasing the epidemiological studies of both strains, as well as the efficacy studies on pertussis vaccination. There is no accepted agreement on treatment and it remains unknown if antimicrobial prophylaxis is indicated in certain clinical settings. We review here the current knowledge on B. holmesii and the need for further research. PMID:26065696

  15. Glutaric aciduria type 1 as a cause of dystonic cerebral palsy

    PubMed Central

    Mohamed, Sarar; Hamad, Muddathir H.; Hassan, Hamdy H.; Salih, Mustafa A.

    2015-01-01

    Glutaric aciduria type 1 (GA1) is an inherited inborn error of metabolism caused by a deficiency of the enzyme glutaryl Co-A dehydrogenase (GCDH). Here, we report a 14-month-old Saudi boy with GA1 who presented with severe dystonia and was mis-diagnosed as cerebral palsy (CP). He presented to our institute with encephalopathy following an episode of gastroenteritis. His physical examination showed dystonia and spastic quadriplegia. His investigations revealed elevated both urinary 3-hydroxy glutaric acid, and serum glutarylcarnitine. The DNA analysis confirmed homozygosity for a mutation in the GCDH-coding gene (c.482G>A;p.R161Q). This case alerts pediatricians to consider GA1 as a differential diagnosis of children presenting with dystonic CP. PMID:26593172

  16. Surgical Management of Unilateral Soft Tissue Swelling around the Proximal Interphalangeal Joint in an Adolescent: A Case Report of Pachydermodactyly

    PubMed Central

    Kato, Naoki; Niitsu, Mamoru; Kawabe, Tetsuya; Arai, Eiichi; Fukumoto, Keizo

    2015-01-01

    Pachydermodactyly (PDD) is a rare and benign acquired form of digital fibromatosis, characterized by asymptomatic fusiform soft tissue hypertrophy of the lateral aspect of the proximal interphalangeal (PIP) joints of the fingers. The etiology of PDD remains unknown, but it usually affects healthy males around the age of puberty. It can be misdiagnosed as inflammatory rheumatic diseases, especially as juvenile chronic arthritis. Here, we report a case of PDD in an 18-year-old man who had progressive fusiform swelling of the PIP joint on his left middle finger. Although he had no pain or functional limitation of movement, he chose to undergo surgical resection of the lesion to obtain a conclusive diagnosis and to rectify the deformity's appearance. Histologically, the lesion was characterized by coarse fibrosis in the adipose tissue, peripheral nerve fibers, and eccrine glands; this is compatible with a diagnosis of PDD. PMID:26688765

  17. Dermatobia hominis: Small Migrants Hidden in Your Skin

    PubMed Central

    Zammarchi, Lorenzo; Viligiardi, Riccardo; Strohmeyer, Marianne

    2014-01-01

    Myiasis is a parasitic infestation of vertebrate animal tissues due to maggots of two-winged flies (Diptera) that feed on living or necrotic tissue. Dermatobia hominis occurs widely in tropical parts of Latin America; it is the most common cause of furuncular myiasis in this region. The continuous increase in international travel has increased the possibility of observing this pathology outside endemic countries, especially in travelers returning from the tropics. If clinicians are aware of the possibility of the disease and its treatment options, this dermatosis can be easily managed. However, diagnostic delay is very common because the disease is often misdiagnosed as a bacterial skin infection. Here, we report 2 cases of furuncular myiasis caused by D. hominis in travelers returning to Italy from Latin America. Surgical and noninvasive treatment approaches are also described. PMID:25324659

  18. Neurobehavioral burden of multiple sclerosis with nanotheranostics.

    PubMed

    Sriramoju, Bhasker; Kanwar, Rupinder K; Kanwar, Jagat R

    2015-01-01

    Multiple sclerosis (MS) is a chronic demyelinating neurological disorder affecting people worldwide; women are affected more than men. MS results in serious neurological deficits along with behavioral compromise, the mechanisms of which still remain unclear. Behavioral disturbances such as depression, anxiety, cognitive impairment, psychosis, euphoria, sleep disturbances, and fatigue affect the quality of life in MS patients. Among these, depression and psychosis are more common than any other neurological disorders. In addition, depression is associated with other comorbidities. Although anxiety is often misdiagnosed in MS patients, it can induce suicidal ideation if it coexists with depression. An interrelation between sleep abnormalities and fatigue is also reported among MS patients. In addition, therapeutics for MS is always a challenge because of the presence of the blood-brain barrier, adding to the lack of detailed understanding of the disease pathology. In this review, we tried to summarize various behavioral pathologies and their association with MS, followed by its conventional treatment and nanotheranostics. PMID:26508863

  19. Hypertension-induced cerebellar encephalopathy and hydrocephalus in a male.

    PubMed

    Lin, Kuang-Lin; Hsu, Wen-Chin; Wang, Huei-Shyong; Lui, Tai-Ngar

    2006-01-01

    Hypertensive encephalopathy is believed to be caused by an abrupt elevation in systemic blood pressure. It rarely occurs in children and can be neurologically devastating if it is not recognized and treated immediately. This report describes an 11-year-old male who presented with edema and a cerebellar lesion, with acute obstructive hydrocephalus resulting from hypertensive encephalopathy. A shunt was inserted to relieve pressure in the acute stage. The patient's hydrocephalus and cerebellar swelling subsided when his blood pressure was controlled. The cerebellar lesion had been initially diagnosed as a glioma. In children, a cerebellar lesion occurring with acute obstructive hydrocephalus and hypertensive encephalopathy is rare but reversible. Clinicians should be aware of this condition because it might be misdiagnosed as a tumor of the posterior fossa. PMID:16376285

  20. Histoplasmosis presenting as isolated cervical lymphadenopathy: A rare presentation

    PubMed Central

    Mishra, Debi Prasad; Ramamurthy, Sindhu; Behera, Samir Kumar

    2015-01-01

    Histoplasmosis is an opportunistic fungal infection caused by inhaling the spores of a fungus called Histoplasma capsulatum. Disseminated histoplasmosis is the most common form associated with acquired immune deficiency syndrome (AIDS). Here, we report a case of histoplasmosis presenting as isolated cervical lymphadenopathy in a human immunodeficiency virus (HIV)-infected patient diagnosed by a less invasive method (fine-needle aspiration cytology) and confirmed by fungal culture of fine-needle aspiration material. Due to varied and nonspecific clinical manifestations of histoplasmosis, most of the infections are misdiagnosed or underreported. It has to be considered in differential diagnosis of cervical lymphadenopathy, particularly in immunocompromised patients so that patients can be treated medically at an early stage before dissemination occurs and unnecessary surgery can be avoided. Here, we present this case because of its rare presentation as isolated cervical lymphadenopathy and classical cytological picture.

  1. Diagnosis and laryngeal complications of Bordatella pertussis infection in the ambulatory adult population.

    PubMed

    Leschke, Thomas M; Blumin, Joel H; Bock, Jonathan M

    2014-11-01

    Bordatella pertussis infection leads to a chronic, debilitating, and paroxysmal cough that can last for months to years. Incidence of B pertussis in the immunized adult population is rising nationwide, but many otolaryngologists are unfamiliar with the diagnosis and management of this disease. Adults often present late in the disease process when traditional diagnostic testing is ineffective and without the classic pediatric symptoms of whooping cough. As a result, B pertussis infections in adults are often overlooked or misdiagnosed as asthma exacerbations or viral bronchitis, leading to increased morbidity, unnecessary testing, and additional exposure of vulnerable populations to the pathogen. This commentary describes 3 adult cases of B pertussis confirmed with serum testing in the ambulatory population and describes varied presentations based on time from initial infection. Specific emphasis is presented on the physical manifestations of the disease in laryngeal structures, methods of diagnosis, and recommendations for treatment. PMID:25205637

  2. Hyperekplexia: a Chinese adolescent with 2 novel mutations of the GLRA1 gene.

    PubMed

    Chan, Keung Kit; Cherk, Sharon Wan-Wah; Lee, Hencher Han-Chih; Poon, Wing Tat; Chan, Albert Yan-Wo

    2014-01-01

    Hyperekplexia is a rare neurologic disorder, characterized by excessive startle response to unexpected stimuli. There are 3 cardinal features: generalized stiffness immediately after birth that normalizes during the first year of life; excessive startle reflex to unexpected (particularly auditory) stimuli; and a short period of generalized stiffness following the startle response while patient cannot elicit voluntary movements. Awareness of this condition will avoid misdiagnosis of disorders like epilepsy. Clonazepam is an effective medical treatment. We report a patient whose frequent falls triggered by sudden noise or tactile stimuli was initially misdiagnosed as epilepsy. The clinical diagnosis was subsequently revised to hyperekplexia and confirmed by mutation analysis of the GLRA1 gene, which showed c.497G>C (p.Cys166Ser) and c.526delG (p.Asp176Metfs*16). Both of them are novel mutations. His response to clonazepam is dramatic and has been able to engage in sports and social activities. PMID:23143726

  3. Extra-articular tenosynovial chondromatosis of the left ring finger in a 23-year-old man: A case report and literature review

    PubMed Central

    CHEN, YU-XIAN; LU, YUN-XIANG; ZHUANG, ZE; LI, ZHI-YONG

    2015-01-01

    Tenosynovial chondromatosis is an extra-articular version of articular synovial chondromatosis and a relatively rare condition that can affect the tendon sheath, bursa, or joint synovial tissue. Tenosynovial chondromatosis is rarely reported in the literature and is often misdiagnosed. In the present study, a case of extra-articular tenosynovial chondromatosis of the left ring finger in a 23-year-old man is reported. Three different-sized nodules were identified upon surgery and all were removed via synovectomy. The patient was symptom free 6 months postoperatively, and there were no signs of recurrence after 1.5 years of follow-up. The literature describing tenosynovial chondromatosis in the fingers is also reviewed. PMID:26622530

  4. A dramatic presentation of an unusual form of cutaneous lymphoma.

    PubMed

    Yang, Sam Shiyao; Su, Pei Qi; Tan, Kong-Bing; Aw, Derrick Chen-Wee

    2015-01-01

    We report an unusual and dramatic presentation of a rare form of cutaneous lymphoma, known as subcutaneous panniculitis-like T-cell lymphoma (SPTCL). This patient presented with a pruritic, florid and purpuric rash that was diagnosed as lobular panniculitis and treated with oral steroids for 1 year with no success. His skin lesions would return each time oral corticosteroids were being weaned off. Upon presentation to our clinic, repeated deep skin biopsies with immunohistochemical analysis coupled with the clinical history of persistent B symptoms and the presence of pancytopenia helped clinched the rare diagnosis of SPTCL with hemophagocytosis. The patient was then started on cyclosporine and dexamethasone before definitive chemotherapy. This rare and diagnostically challenging condition is commonly misdiagnosed as benign panniculitis or eczema, and highlights the importance of repeated skin biopsies. PMID:26288445

  5. Refeeding syndrome in a young girl with anorexia nervosa.

    PubMed

    Parkash, Om; Ayub, Adil; Abid, Shahab

    2014-05-01

    We report the case of a 20-year-old anorexic girl (BMI=12.9), who was misdiagnosed the first time and developed severe electrolyte imbalances due to lack of awareness about refeeding syndrome. Few cases of RS have been reported in literature and protocols have been suggested for prevention and management of this syndrome, including the awareness of circumstances in which it is most likely to develop, refeeding slowly and building-up micronutrient content over several days. Improved awareness and understanding of refeeding syndrome along with a well-coordinated plan are vital in delivering safe and effective nutritional rehabilitation. We suggest a slow and gradual increase in nutrition along with nutritional counselling and psychotherapy. PMID:24906279

  6. [Incidents in reposition of smallpox virus laboratories and its retrospect and ponderation].

    PubMed

    Grant, Alicia

    2013-07-01

    Reposition of variola virus in some laboratories in the UK led to some serious incidents before the announcement by WHO of the Global Eradication of Smallpox in 1980. These three incidents resulted in 78 people recorded as infected with smallpox, among them 3 died, with very many others misdiagnosed at the time as suffering from chickenpox. Therefore WHO discussed the problems and decided to reduce gradually the number of repositories of variola virus in laboratories world-wide from previously unknown numbers to two. However, suppose in the event of a sudden outbreak of a new, mutated species of smallpox virus, what should we do? Maybe, the obsolete ancient prophylactic practice of variolation could be of considerable contingency value. PMID:24345545

  7. Tularemia in children, Turkey, September 2009-November 2012.

    PubMed

    Tezer, Hasan; Ozkaya-Parlakay, Asl?nur; Aykan, Hakan; Erkocoglu, Mustafa; Gülhan, Belgin; Demir, Ahmet; Kanik-Yuksek, Saliha; Tapisiz, Anil; Polat, Meltem; Kara, Soner; Devrim, Ilker; Kilic, Selcuk

    2015-01-01

    Tularemia, a zoonotic disease caused by Francisella tularensis, is found throughout most of the Northern Hemisphere. It is not well known and is often misdiagnosed in children. Our aim with this study was to evaluate the diagnosis, treatment, and prognosis for 100 children with tularemia in Turkey. The mean patient age was 10.1 ± 3.5 years (range 3-18 years), and most (63%) patients were male. The most common physical signs and laboratory findings were cervical lymphadenopathy (92%) and elevated erythrocyte sedimentation rate (89%). Treatment response was higher and rate of relapse lower for children 5-10 years of age than for those in other age groups. Associated with treatment failure were female sex, treatment delay of ?16 days, and use of doxycycline. Tularemia is endemic to Turkey, and the number of cases has been increasing among children as well as adults. PMID:25529639

  8. Chikungunya virus infection, a threat to public health.

    PubMed

    Islam, M N; Hossain, M A; Khaleque, M A; Karim, M R; Khan, M R; Mia, A H; Ali, M S

    2012-04-01

    Many countries in the world have reported human infections by chikungunya virus (CHIKV) a mosquito-borne togavirus belonging to the genus alpha virus. After half a century of focal out breaks of acute febrile poly arthralgia, the disease had spread unexpectedly in the past decade with large outbreaks in Africa around the Indian Ocean and in Bangladesh. In Asia, CHIKV is thought to be transmitted by the same mosquito as dengue, Aedes aegypti and Aedes albopictus. Due to similarities in clinical presentation with dengue, limited awareness and a lack of laboratory diagnostic facilities, CHIKV is probably often under diagnosed or misdiagnosed as dengue. Treatment is supportive. The prognosis is generally good although some patients experience chronic arthritis. There is no vaccine or antiviral therapy against CHIKV. Early identification of disease and control of vector will prevent the spread of disease. PMID:22561790

  9. Tinea capitis caused by Trichophyton tonsurans presenting as an obscure patchy hair loss due to daily antifungal shampoo use.

    PubMed

    Sombatmaithai, Alita; Pattanaprichakul, Penvadee; Tuchinda, Papapit; Surawan, Theetat; Muanprasart, Chanai; Matthapan, Lalita; Bunyaratavej, Sumanas

    2015-04-01

    Tinea capitis is unusual and often misdiagnosed in healthy adults. We report a case of a healthy woman with a several-year history of asymptomatic, bizarre-shaped, non-scarring alopecia. She had used over-the-counter ketoconazole shampoo regularly for a long time. An initial potassium hydroxide preparation showed negative result for fungal organism. The scalp biopsy revealed endothrix infection, and dermoscopic examination demonstrated the comma hair and corkscrew hair signs. The fungal culture showed Trichophyton tonsurans. The daily use of antifungal shampoo could be the important factor to conceal clinical and laboratory findings for diagnosis of T. tonsurans tinea capitis in our case, which required high clinical suspicion and histopathology and dermoscopic examinations. PMID:26114071

  10. Autoimmune pancreatitis mimicking Klatskin tumour on radiology.

    PubMed

    Hadi, Yousaf Bashir; Sohail, Abdul Malik Amir Humza; Haider, Zishan

    2015-01-01

    Autoimmune pancreatitis (AIP) is categorised into two distinct types, AIP type 1 and 2. Although there can be multisystem involvement, rarely, the cholangitis associated with AIP can present radiologically in a manner similar to that of Klatskin tumour. We present the case of a 65-year-old man who was almost misdiagnosed with a Klatskin tumour because of the similarity in radiological features of the two aforementioned clinical entities. The patient presented with a history of jaundice, pruritus and abdominal pain, and work up showed deranged liver function tests, elevated cancer antigen 19-9 levels and positive antinuclear antibodies. CT scan of the abdomen showed findings suggestive of Klatskin tumour but due to diffuse enlargement of the pancreas and surrounding low-attenuation halo found on a closer review, a diagnosis of AIP was performed. The patient was started on standard corticosteroid therapy and responded well, with complete resolution of the radiological findings. PMID:25858920

  11. Acute promyelocytic leukemia presenting as pulmonary thromboembolism: Not all APLs bleed.

    PubMed

    Vaid, Ashok K; Batra, Sandeep; Karanth, Suman S; Gupta, Sachin

    2015-01-01

    We present a rare case of acute promyelocytic leukemia (APL) presenting as pulmonary thromboembolism being misdiagnosed as community-acquired pneumonia. Thrombotic phenomenon in APL are poorly understood and grossly underreported. In our case, following no response to standard antibiotic treatment, the patient was further investigated and detected to have an acute pulmonary thromboembolism following right lower limb deep vein thrombosis (DVT). Though, complete blood picture revealed only mild hyperleukocytosis, bone marrow biopsy and aspiration revealed 60% blasts and a positive t (15,17)(q22,12) and PML retinoic acid receptor alpha (RARA) fusion protein on molecular cytogenetics. He was diagnosed as APL and received treatment with all-transretinoic acid (ATRA) and arsenic trioxide (ATO) and therapeutic anticoagulation. PMID:26629469

  12. [Gout in the past and uric arthritis today in Croatia] ].

    PubMed

    Cunovi?, S; Cunovi?-Dubroja, R

    2001-01-01

    In the past, gout was well known in these places, from Istria to Dubrovnik. Our very first dictionaries also witness about gout. Old doctors from Krapinske Toplice had also written about gout. Dr Edmund Mai, in his article published in "Lijecnicki vjesnik" in 1904 mentions "171 cases of uric arthritis". But, after that, for long 60 years there wasn't even a word about our patients, except surprise on very high incidence of the disease in the past. Even our handbooks had claimed that uric arthritis is not common in our country. In 1964 after 60 years of silence, the first article about our patients with uric arthritis, was published in "Lijecnicki vjesnik". These patients were medically treated for average of 13 years, and still were misdiagnosed. After that article, the numbers of patients with gout and articles on uric arthritis permanently rise. Today, the incidence of gout in Croatia is similar to that in other European countries. PMID:11845585

  13. Orofacial tuberculosis: Clinical manifestations, diagnosis and management

    PubMed Central

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

    Orofacial tuberculosis (TB) is an uncommon form of extrapulmonary TB and is nonspecific in its clinical presentation. It can be misdiagnosed especially when oral lesions are present before systemic symptoms become apparent. Doctors especially attending dentist who generally is the first among clinicians to come across such pathological entity should be aware of the orofacial lesions of TB and consider them in the differential diagnosis of suspicious oral lesions to ensure early diagnosis of TB and its treatment. In this review, we have discussed in detail the clinical presentation of various forms of orofacial TB, diagnosis, and management of patients. Also, an update is provided about recent anti-TB drug development. PMID:26288770

  14. Detecting the emergence of novel, zoonotic viruses pathogenic to humans

    PubMed Central

    2015-01-01

    RNA viruses, with their high potential for mutation and epidemic spread, are the most common class of pathogens found as new causes of human illness. Despite great advances made in diagnostic technology since the 1950s, the annual rate at which novel virulent viruses have been found has remained at 2–3. Most emerging viruses are zoonoses; they have jumped from mammal or bird hosts to humans. An analysis of virus discovery indicates that the small number of novel viruses discovered annually is an artifact of inadequate surveillance in tropical and subtropical countries, where even established endemic pathogens are often misdiagnosed. Many of the emerging viruses of the future are already infecting humans but remain to be uncovered by a strategy of disease surveillance in selected populations. PMID:25416679

  15. Large twisted ovarian fibroma in menopausal women: a case report

    PubMed Central

    Boujoual, Majdouline; Hakimi, Ihsan; Kouach, Jaouad; Oukabli, Mohamed; Moussaoui, Driss Rahali; Dehayni, Mohammed

    2015-01-01

    Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older perimenopausal and postmenopausal women. Occasionally large fibromas may undergo torsion causing acute abdominal pain. Doppler Ultrasonographyimaging is the choice study. CT and MRI are often needed for further characterization and differentiation from other solid ovarian masses. The choice treatment is surgical removal with intraoperative frozensection. Immunohistochemicalanalysis is recommended to rule out the differential diagnosis. Here we present a case of a postmenopausal woman with a large twisted ovarian fibroma reflecting diagnostic and management difficulties including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the surgical approach. PMID:26175813

  16. [Diagnostic errors in angiomas].

    PubMed

    Kämpfer, R; Hundeiker, M

    1977-11-01

    A comparison of clinical statements and histologic findings reveals a lower diagnostic success in angiomas, compared with other benign tumours. Cavernous forms of angiomas are very often not discerned. Capillary angiomas are misdiagnosed as cavernous ones, and teleangiectatic nevi as angiomas. Mistakes and their incidences are pointing not at real difficulties of differentialdiagnosis, but at wrong information of physicians as to the cause of errors. According to this supposition, a great part of textbooks in different medical disciplines offer no correct representation of this object. Our results reveal problems concerning the representation of some aspects of skin diseases outside of Dermatology. The diagnosis of angiomas, with special regard to the therapeutic consequences of the fundamental distinction of angiomas from angiectatic nevi by proliferation of endothelial cells, and of cavernous from capillary angiomas by vascular structure imitating arteries or veins, demands more attention in medical education. PMID:930226

  17. A Rare Cause of Low Back Pain: Report of a Tailgut Cyst

    PubMed Central

    Joyce, E. A.; Kavanagh, D. O.; Winter, D. C.

    2012-01-01

    Tailgut cysts, also known as retrorectal cystic hamartomas, are rare developmental abnormalities that typically occur in the retrorectal space. They are believed to arise from remnants of the embryonic hindgut (Hjermstad and Helwig, 1988). They can present as incidental findings during routine examination but over half of patients are thought to present with symptoms. MRI has become the modality of choice to image these frequently misdiagnosed cysts. Biopsy is not recommended. Complete intact surgical excision is advised to avoid the potential complications of these cysts which include infection, fistula formation, and the possibility of malignant transformation (Hjermstad and Helwig (1988), Mathis et al. (2010)). We describe the case of a 46-year-old female who presented with a 6-month history of low back pain. CT and MRI imaging demonstrated a complex retrorectal lesion with supralevator and infralevator components. This was removed using a combined transperineal and transabdominal approach. Histology confirmed a tailgut cyst. PMID:22431937

  18. Laparoscopic approach to retrorectal cyst

    PubMed Central

    Gunkova, Petra; Martinek, Lubomir; Dostalik, Jan; Gunka, Igor; Vavra, Petr; Mazur, Miloslav

    2008-01-01

    Retrorectal cysts are rare benign lesions in the presacral space which are frequently diagnosed in middle-aged females. We report here our experience with two symptomatic female patients who were diagnosed as having a retrorectal cyst and managed using a laparoscopic approach. The two patients were misdiagnosed as having an ovarian cystic lesion after abdominal ultrasonography. Computer tomography (CT) scan was mandatory to establish the diagnosis. The trocar port site was the same in both patients. An additional left oophorectomy was done for a coexisting ovarian cystic lesion in one patient in the same setting. There was no postoperative morbidity or mortality and the two patients were discharged on the 5th and 6th post operative days, respectively. Our cases show that laparoscopic management of retrorectal cysts is a safe approach. It reduces surgical trauma and offers an excellent tool for perfect visualization of the deep structures in the presacral space. PMID:19030218

  19. Focal cemento-osseous dysplasia of mandible

    PubMed Central

    Cankaya, Abdülkadir Burak; Erdem, Mehmet Ali; Olgac, Vakur; Firat, Deniz Refia

    2012-01-01

    Fibro-osseous lesions are disturbances in bone metabolism in which normal bone is replaced by a connective tissue matrix that then gradually develops into cemento-osseous tissue. Typically, the lesion is asymptomatic and is detected on routine radiographic examination. Radiologically, this lesion has three stages of maturation: pure radiolucent, radiopaque/mixed radiolucent, and radiopaque appearance. During these stages the lesion can be misdiagnosed. In this case report a 69-year- old patient with a a complaint of painless swelling of the left mandibular molar and premolar area is presented along with a review of the differential diagnoses considered in order to reach a final diagnosis of focal cemento-osseous dysplasia. PMID:22948991

  20. A Case of Simultaneous Unilateral Anterior and Posterior Stafne Bone Defects

    PubMed Central

    Ozaki, Hisashi; Ishikawa, Shigeo; Kitabatake, Kenichirou; Yusa, Kazuyuki; Tachibana, Hirohiko; Iino, Mitsuyoshi

    2015-01-01

    Stafne bone defects (SBDs) are asymptomatic mandibular lingual bone depressions mainly caused by soft tissue inclusions. The most common form of SBDs is posterior; the anterior variant of SBD is relatively uncommon. Although posterior SBD is easily diagnosed by the unique location on radiography, anterior SBD is sometimes misdiagnosed and confused with other pathological entities owing to the location. We report herein a case of simultaneous unilateral anterior and posterior SBDs. In the present case, definitive diagnosis for the anterior mandibular cavity was unclear, as in reported cases. Surgical exploration was thus performed for the lesion in the anterior mandibular cavity. Pathologic examination of the removed tissue showed salivary gland with chronic inflammation. Postoperatively, no functional disturbance has been observed. Management of the posterior SBD was conservative, with radiographic follow-up. To the best of our knowledge, this represents the first report of simultaneous unilateral anterior and posterior SBDs. PMID:26605094

  1. Pachydermodactyly: a review.

    PubMed

    Dallos, Tomáš; Oppl, Bastian; Kovács, László; Zwerina, Jochen

    2014-01-01

    Synovitis is the characteristic feature of inflammatory joint disease. If synovitis is localized to interphalangeal joints, rheumatoid arthritis, psoriatic arthritis, and juvenile idiopathic arthritis are among the most common differential diagnoses. The absence of pain, tenderness, and limitation of function despite progressive swelling of proximal interphalangeal joints suggests an alternative diagnosis, for example pachydermodactyly (PDD). This is a benign disease, associated with asymptomatic, progressive swelling of periarticular soft tissue, which usually occurs in young males. PDD is probably the result of repetitive mechanical stimulation. One hundred and twenty-one cases have been reported in the literature. Some of these were initially misdiagnosed and treated for inflammatory arthritis. We provide a comprehensive review of the literature on pachydermodactyly to promote awareness of this rare but important differential diagnosis of arthritis. PMID:25173950

  2. Epithelioid Hemangioendothelioma of Tibia and Talus: A Case Report

    PubMed Central

    Kumar, Dharmendra; Jain, Vijay K.; Bhardwaj, Meenakshi; Naik, Ananta K.; Nasa, Ruchi; Arya, Rajendra K.

    2015-01-01

    Epithelioid hemangioendothelioma (EHE) of the bone is extremely uncommon and consists of less than 1% of primary bone tumors. It is characterized by epithelioid endothelial cells and has variable biological behavior. EHE is more likely to occur between 20 and 30 years of age. Approximately half of EHE present with multifocal disease. Since the behavior of these tumors is intermediate, it is important to not misdiagnose EHE as an angiosarcoma. Here we describe the case of a 43-year-old male who presented with pain and swelling of the leg and ankle to Dr. Ram Manohar Lohia Hospital, India. Radiography and computed tomography of the ankle and leg were performed and suggested an expansile lytic lesion involving the distal tibia and talus bone. The lesion was excised and ankle arthrodesis performed. Histological evaluation of the lesion demonstrated the presence of EHE of the tibia and talus. PMID:26366265

  3. Orocutaneous Fistula or Traumatic Infectious Skin Lesion: A Diagnostic Dilemma

    PubMed Central

    Vermani, Mayank; Kalia, Vimal; Singh, Sumita; Garg, Sunny; Aggarwal, Shweta; Khurana, Richa; Kalra, Geeta

    2015-01-01

    Orocutaneous fistula (OCF) (of dental origin) is an uncommon but well-described condition in the literature. These are often misdiagnosed by physicians and dentists. Careful selection of investigating modality is important in case of diagnostically challenging cases. A 19-year-old female came with a complaint of a lesion on the chin reported with h/o trauma with the impact on chin presented as diagnostic dilemma because of unusual case history and clinical examination. Commonly used radiographic investigations like IOPA and orthopantomograph did not resolve the dilemma whereas advanced imaging modality like CT scan, 3D volume imaging, and contrast enhanced CT played an important role in the diagnosis of OCF and selecting the treatment plan. PMID:26618009

  4. The Primary Care Physician in the Early Diagnosis of Systemic Sclerosis: the Cornerstone of Recognition and Hope

    PubMed Central

    Saketkoo, Lesley Ann; Magnus, Jeanette H.; Doyle, Mittie K.

    2013-01-01

    Systemic sclerosis (SSc) is a disease of unknown etiology that manifests as a heterogeneous group of multi-organ system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Due to late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists. PMID:24366221

  5. Datura stramonium toxicity mistakenly diagnosed as "bath salt" intoxication: a case report.

    PubMed

    Melvin, Kelly; Hourani, David

    2014-01-01

    Datura stramonium is a wildly growing plant found in West Virginia and in temperate regions throughout the world that is sometimes abused by young people because of its hallucinogenic effects. D. Stramonium overdose produces a classic anticholinergic syndrome that can lead to severe and sometimes fatal complications. Poisoning can be confused with more commonly seen drugs of abuse, particularly synthetic drugs which are not revealed by standard drug screens. Misdiagnosis can delay appropriate care and potentially lead to poorer outcomes. We present a case of a 15 year-old male with acute D. Stramonium poisoning initially misdiagnosed with bath salt intoxication who required treatment by two emergency departments, a pediatric ICU, and who was ultimately transferred to an inpatient psychiatric facility. We then discuss differential diagnosis of D. Stramonium poisoning and bath salt intoxication and present management strategies for the two conditions. PMID:24640270

  6. A history of recurrent wheezing can delay the diagnosis of foreign body aspiration in a paediatric emergency department.

    PubMed

    Colavita, Laura; Gelli, Claudia; Pecorari, Lisa; Peroni, Diego Giampietro

    2015-01-01

    Foreign body aspiration (FBA) into the airways is a potentially life-threatening event, and more frequent in children younger than 3?years of age; it can mimic other diseases by its frequently non-specific clinical and radiological presentation. The commonest misdiagnoses in children are asthma and recurrent respiratory tract infections with wheezing. This often makes it particularly difficult for a timely and proper diagnosis, especially when there is a silent history of FBA (not a rare occurrence in the age group at highest risk). We report a case of a 2-year-old boy who arrived at the emergency department at the Hospital of Ferrara, with dyspnoea, fever and wheezing, which had started 12?h after aspiration of a pistachio. The asymptomatic period after the pistachio aspiration, a history of recurrent wheezing during respiratory infections and the non-specificity of clinical and radiological findings, delayed the right diagnosis of FBA. PMID:26351317

  7. Solitary fibrous tumors of the prostate: A case report

    PubMed Central

    YANG, WENYAN; SUN, FUGUANG; LIU, HONGJUN; WANG, GUANGJIAN; SHI, PEIQING; SHAO, ZHIQIANG; GUO, FENGFU

    2015-01-01

    Increasing numbers of extrapleural solitary fibrous tumours (SFTs), including the prostate SFT, have been reported over the last 10-years. Prostate SFT is relatively uncommon, with <20 cases reported in the literature worldwide. In the present study, a prostate SFT case, which was initially misdiagnosed as benign prostatic hyperplasia, is presented. The patient was subjected to three surgeries (cystoscopy and per urethra lithocystotomy, transurethral resection of the prostate and nerve-sparing retropubic radical prostatectomy) prior to SFT diagnosis. It was demonstrated that histopathological and immunohistochemical factors (positive staining for CD34 and B cell lyphoma-2 expression) were of significant diagnostic value. Thus, nerve-sparing retropubic radical prostatectomy for total resection may be the best therapeutic strategy to treat prostate SFT, allowing the preservation of sexual function and reducing the risk of locoregional recurrence. PMID:26622720

  8. Coil embolization for a vast and complex arteriovenous malformation in the posterior mediastinum

    PubMed Central

    Li, Jun; Liu, Hui; Ye, Ling

    2015-01-01

    Arteriovenous malformation (AVM) is a kind of life threatened disease. Especially AVM in the posterior mediastinum is a rare, painful and it is difficult for treatment. We report a 44-year-old male patient who developed arteriovenous malformation (AVM) in the posterior mediastinum. The patient complained 3 years of mild left back pain and chest congestion, and his pain increased over the last 3 months. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) examinations showed an enhancing vascular lesion in the left posterior mediastinum which in contact with the descending thoracic aorta. It was initially misdiagnosed as lung mass. It was considered to be vascular malformations. His pain was completely resolved after steel coil embolization was successfully administered.

  9. Depression in the aged. An overview.

    PubMed

    Ruegg, R G; Zisook, S; Swerdlow, N R

    1988-03-01

    Depression in the aged is common and associated with substantial medical and social morbidity and mortality. It is often missed or misdiagnosed because of masked or somatic symptoms, delusions, and pseudodementia. At any given time, about 2 per cent of the elderly have major depression and a third to a half of older psychiatric inpatients and outpatients have mood disorders. Aged depressives have more somatization, hypochondriasis, anxiety, retardation, and delusionality but less guilt, loss of libido, and family history of depression than young ones. Both the illnesses common in the elderly and the medicines used to treat them may be etiologically connected with depression. After precipitating causes are remedied, remaining symptoms respond to antidepressant treatment. Medication doses are much lower and side effects more troublesome. ECT or concomitant antipsychotic medication are more likely to be indicated. PMID:3288982

  10. Sight and blindness in the same person: Gating in the visual system.

    PubMed

    Strasburger, Hans; Waldvogel, Bruno

    2015-12-01

    We present the case of a patient having dissociative identity disorder (DID) who-after 15 years of misdiagnosed cortical blindness-step-by-step regained sight during psychotherapeutic treatment. At first only a few personality states regained vision whereas others remained blind. This could be confirmed by electrophysiological measurement, in which visual evoked potentials (VEPs) were absent in the blind personality states but were normal and stable in the seeing states. A switch between these states could happen within seconds. We assume a top-down modulation of activity in the primary visual pathway as a neural basis of such psychogenic blindness, possibly at the level of the thalamus. VEPs therefore do not allow separating psychogenic blindness from organic disruption of the visual pathway. In summary, psychogenic blindness seems to suppress visual information at an early neural stage. PMID:26468893

  11. Skeletal and cranio-facial signs in Gorlin syndrome from ancient Egypt to the modern age: sphenoid asymmetry in a patient with a novel PTCH1 mutation.

    PubMed

    Ponti, Giovanni; Ruini, Cristel; Pastorino, Lorenza; Loschi, Pietro; Pecchi, Annarita; Malagoli, Marcella; Mandel, Victor Desmond; Boano, Rosa; Conti, Andrea; Pellacani, Giovanni; Tomasi, Aldo

    2014-05-01

    Gorlin syndrome is an autosomal dominant disorder linked to PTCH1 mutation, identified by a collection of clinical and radiologic signs. We describe the case of a family in which father and son fulfilled clear cut diagnostic criteria for Gorlin syndrome including multiple basal cell carcinomas, keratocystic odontogenic tumors, atypical skeletal anomalies and a novel PTCH1 germline mutation (c.1041delAA). Craniofacial and other skeletal anomalies displayed at 3D and helical CT scan were: macrocephaly, positional plagiocephaly, skull base and sphenoid asymmetry, bifidity of multiple ribs and giant multilocular odontogenic jaw cysts. Extensive multilamellar calcifications were found in falx cerebri, tentorium, falx cerebelli and in the atlanto-occipital ligament. The inclusion of bifid ribs as a novel major criteri may be useful for the recognition and characterization of misdiagnosed cases. PMID:24941978

  12. Urticaria Multiforme

    PubMed Central

    Bernardo, Sebastian G.; Kovalerchik, Olga; Ahmad, Moneeb

    2013-01-01

    Urticaria multiforme is a benign cutaneous hypersensitivity reaction seen in pediatric patients that is characterized by the acute and transient onset of blanchable, annular, polycyclic, erythematous wheals with dusky, ecchymotic centers in association with acral edema. It is most commonly misdiagnosed as erythema multiforme, a serum-sickness-like reaction, or urticarial vasculitis. Since these three diagnoses represent distinct clinical entities with unique prognoses and management strategies, it is important that physicians distinguish urticaria multiforme from its clinical mimics in order to optimize patient care. By performing a thorough history and physical examination, the astute clinician can make the correct diagnosis and develop an appropriate, effective treatment plan while avoiding unnecessary biopsies and laboratory evaluations. The authors report a case of urticaria multiforme in a four-year-old girl in order to emphasize the distinctive morphological manifestations of this rare, albeit unique, disease seen in the pediatric population. PMID:23556035

  13. The relation between celiac disease, nonceliac gluten sensitivity and irritable bowel syndrome.

    PubMed

    El-Salhy, Magdy; Hatlebakk, Jan Gunnar; Gilja, Odd Helge; Hausken, Trygve

    2015-01-01

    Wheat products make a substantial contribution to the dietary intake of many people worldwide. Despite the many beneficial aspects of consuming wheat products, it is also responsible for several diseases such as celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity (NCGS). CD and irritable bowel syndrome (IBS) patients have similar gastrointestinal symptoms, which can result in CD patients being misdiagnosed as having IBS. Therefore, CD should be excluded in IBS patients. A considerable proportion of CD patients suffer from IBS symptoms despite adherence to a gluten-free diet (GFD). The inflammation caused by gluten intake may not completely subside in some CD patients. It is not clear that gluten triggers the symptoms in NCGS, but there is compelling evidence that carbohydrates (fructans and galactans) in wheat does. It is likely that NCGS patients are a group of self-diagnosed IBS patients who self-treat by adhering to a GFD. PMID:26345589

  14. Pigmented Perivascular Epithelioid Cell Tumor of the Skin: First Case Report.

    PubMed

    Navale, Pooja; Asgari, Masoud; Chen, Sheng

    2015-11-01

    The authors present a first case of pigmented perivascular epithelioid cell tumor (PEComa) of the skin, which was misdiagnosed histopathologically as metastatic melanoma. PEComa are exceedingly rare neoplasms, and only a few cases have been reported in kidney, liver, and pelvis. Herein, we describe this very rare entity in the subcutaneous tissue of the flank with very similar if not identical morphology of renal clear cell carcinoma. Because of the presence of focal melanin pigmentation and strong positivity for HMB-45, the lesion was mistaken for metastatic melanoma. To the best of authors' knowledge, this is the first case of cutaneous PEComa with melanin pigmentation. Awareness about occurrence of the lesion in the subcutaneous tissue and its unique immunoprofile would be helpful to reach correct diagnosis and to distinguish this lesion from melanoma or metastatic renal clear cell carcinoma. PMID:26355762

  15. [Dissociative disorder--the concept and its history].

    PubMed

    Okano, Kenichiro

    2011-01-01

    Dissociative disorder is both an old and a new mental disorder. Its forerunner, hysteria, was a poorly understood and often grossly misconceived notion that might date back as far as human societies existed, but it has been treated as a new disorder since it emerged in the DSM-III. A century ago, Sigmund Freud and Pierre Janet, two giants in the history of dynamic psychiatry, were deeply influenced by dissociative phenomena, and created their own theory of human mind with very different orientations. The reemergence of dissociative disorders in the current psychiatry has several implications. It helps clinicians understand mental conditions that they did not know how to define and classify based on the traditional psychiatry. It also allows clinicians to identify a population that was misdiagnosed with other diagnostic categories, such as borderline personality disorder and schizophrenia. PMID:22117394

  16. Clinical and molecular genetic analysis of a Chinese family with congenital X-linked adrenal hypoplasia caused by novel mutation 1268delA in the DAX-1 gene*

    PubMed Central

    ZHANG, Zhe; FENG, Ye; YE, Dan; LI, Cheng-jiang; DONG, Feng-qin; TONG, Ying

    2015-01-01

    Congenital X-linked adrenal hypoplasia (AHC) is a rare disease characterized by primary adrenal insufficiency before adolescence and by hypogonadotropic hypogonadism (HHG) during adolescence. In this paper, we present a Chinese family with AHC. Two brothers, misdiagnosed with adrenal insufficiency of unknown etiology at the age of 9, were correctly diagnosed with AHC when delayed puberty, HHG, and testicular defects were observed. We investigated the clinical features and identified the dosage-sensitive sex reversal AHC critical region of the X chromosome gene 1 (DAX-1) mutation in this kindred. Direct sequencing of the DAX-1 gene revealed that the two siblings have a novel mutation (1268delA) of which their mother is a heterozygous carrier. This mutation causes a frameshift and a premature stop codon at position 436, encoding a truncated protein. It is important to increase knowledge of the mutational spectrum in genes related to this disease, linking phenotype to genotype. PMID:26537215

  17. Diagnosis and Management of Behavioral Variant Frontotemporal Dementia

    PubMed Central

    Pressman, Peter; Miller, Bruce L

    2014-01-01

    Frontotemporal dementia (FTD) was documented over a century ago. The last decade, however, has seen substantial changes in our conceptions of this increasingly recognized disorder. Different clinical variants have been delineated, the most common of which is the behavioral variant (bvFTD). Updated diagnostic criteria have been established. New histopathological findings and genetic etiologies have been discovered. Research continues to uncover molecular mechanisms by which abnormal proteins accumulate in degenerating brain tissue. Novel neuroimaging techniques suggest that functional networks are diminished in bvFTD that may be relevant to empathy and social behavior. Despite rapid advances in our understanding of bvFTD, the disease is still under-recognized and commonly misdiagnosed. The result is inappropriate patient care. Recognizing the various presentations of bvFTD and its histological and genetic subtypes may further diagnosis, treatment and research. PMID:24315411

  18. Unusual unilateral presentation of pachydermodactyly: a case report.

    PubMed

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions. PMID:21442169

  19. Incontinence-associated dermatitis: identification, prevention and care.

    PubMed

    Holroyd, Sharon

    Incontinence-associated dermatitis (IAD) is a common skin disorder experienced by people who suffer from faecal and/or urinary incontinence. It is painful and in some cases accompanied by significant secondary infections. The prevalence is higher in those people receiving long-term care at home. IAD is often misdiagnosed and confused with pressure ulcers. Care providers now crossover health and social care boundaries and education on continence-related issues is often not prioritised. This article looks at normal skin physiology and the aetiology of IAD versus pressure ulcers. It suggests prevention and management strategies in relation to IAD; in particular, the use of barrier creams. A selection of case studies evaluating the efficacy of using Cutimed PROTECT cream in cases of IAD are presented. PMID:25978474

  20. Disseminated Cutaneous Leishmaniasis in Colombia: Report of 27 Cases.

    PubMed

    Vélez, Iván D; Jiménez, Alejandra; Vásquez, Daniel; Robledo, Sara M

    2015-01-01

    Disseminated leishmaniasis (DL) is a poorly described disease that is frequently misdiagnosed as other clinical manifestations of cutaneous leishmaniasis (CL) such as diffuse CL or post-kala-azar dermal leishmaniasis. Twenty-seven cases of DL diagnosed between 1997 and 2015 are described. A higher prevalence was observed in men (mean age 32 years). The number of lesions per patient ranged from 12 to 294, distributed mainly in the upper extremities, face and trunk. The lesions were mostly plaques or nodules. Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases. Eighteen patients recovered with pentavalent antimonial. The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis. PMID:26557074

  1. Disseminated Cutaneous Leishmaniasis in Colombia: Report of 27 Cases

    PubMed Central

    Vélez, Iván D.; Jiménez, Alejandra; Vásquez, Daniel; Robledo, Sara M.

    2015-01-01

    Disseminated leishmaniasis (DL) is a poorly described disease that is frequently misdiagnosed as other clinical manifestations of cutaneous leishmaniasis (CL) such as diffuse CL or post-kala-azar dermal leishmaniasis. Twenty-seven cases of DL diagnosed between 1997 and 2015 are described. A higher prevalence was observed in men (mean age 32 years). The number of lesions per patient ranged from 12 to 294, distributed mainly in the upper extremities, face and trunk. The lesions were mostly plaques or nodules. Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases. Eighteen patients recovered with pentavalent antimonial. The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis. PMID:26557074

  2. Simultaneous occurrence of keratocystic odontogenic tumor and ameloblastoma in the mandible: A case report

    PubMed Central

    GAMOH, SHOKO; AKIYAMA, HIRONORI; TOMINAGA, KAZUYA; NAKAJIMA, MASAHIRO; KAKUDO, KENJI; TANAKA, AKIO; SHIMIZUTANI, KIMISHIGE

    2015-01-01

    Keratocystic odontogenic tumors (KCOTs) and ameloblastomas are benign odontogenic tumors that primarily occur in the molar region of the mandible. However, it is uncommon for these tumors to arise simultaneously in a patient's jaw. The present study reported the diagnostic process and features of a rare case of the simultaneous occurrence of KCOT and ameloblastoma in the mandible of a 45-year-old male. Image-based diagnosis was challenging due to several conditions, including the intactness of the teeth and bone cortex as well as the sizes and locations of the lesions. Based on radiographic evidence, the patient was initially misdiagnosed and underwent a biopsy for a radicular cyst and a simple bone cyst prior to the correct diagnoses of KCOT and ameloblastoma, respectively. In addition, the present study discussed the diagnostic process of the present case and reviewed previous literature regarding the simultaneous occurrence of benign tumors of the jaw. PMID:26622570

  3. Spontaneous splenic rupture in pregnancy

    PubMed Central

    Elghanmi, Adil; Mohamed, Jou; Khabouz, Samira

    2015-01-01

    Splenic rupture during pregnancy is a rare and can frequently be a misdiagnosed pathology. This rupture is associated with a high maternal and fetal mortality rate. A 26 years old Moroccan woman para II gravida II presented at the third stage of pregnancy with acute onset of severe abdominal pain. She developed immediately a hypovolemic shock. After both a physical and sonographical exam, it was revealed that it was due to a massive hemoperitoneum. Therefore, an emergent laparotomy and cesarean delivery with abdominal exploration were performed; also, an active bleeding was identified at the splenic hilum consistent with splenic rupture. Through this case report, we want to raise awareness of this surgical emergency that requires immediate recognition because any delay can lead to catastrophic consequences

  4. A Case of Rupioid Syphilis Masquerading as Aggressive Cutaneous Lymphoma

    PubMed Central

    Braue, Jonathan; Hagele, Thomas; Yacoub, Abraham Tareq; Mannivanan, Suganya; Sokol, Lubomir; Glass, Frank; Greene, John N.

    2015-01-01

    Secondary syphilis has been known since the late 19th century as the great imitator; however, some experts now regard cutaneous lymphoma as the great imitator of skin disease. Either disease, at times an equally fastidious diagnosis, has reported to mimic each other even. It is thus vital to consider these possibilities when presented with a patient demonstrating peculiar skin lesions. No other manifestation of secondary syphilis may pose such quandary as a rare case of rupioid syphilis impersonating cutaneous lymphoma. We present such a case, of a 36-year-old HIV positive male, misdiagnosed with aggressive cutaneous lymphoma, actually exhibiting rupioid syphilis thought secondary to immune reconstitution inflammatory syndrome (IRIS). PMID:25960854

  5. The stone man disease: fibrodysplasia ossificans progressiva: imaging revisited

    PubMed Central

    Verma, Amit Kumar; Aga, Pallavi; Singh, Shailesh Kumar; Singh, Ragini

    2012-01-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare, disabling connective tissue disorder of unknown aetiology. Its occurrence is usually sporadic but may be an inherited autosomal-dominant condition with wide range of expression. FOP is characterised by congenital malformations of the great toes and abnormal progressive heterotopic ossification of striated muscles, tendons, ligaments, fascia and aponeuroses of the trunk and extremities leading to painful swellings. The ossifications typically appear within the first decade of life, resulting in progressive morbidity and severe disability. So far, there has been no effective treatment or prevention. In the early localised phase of disease it may be misdiagnosed, hence the role of correct diagnosis through imaging is essential. Herein, we report a case of a 10-year-old female who was evaluated radiologically and diagnosed as a case of FOP. The findings of plain radiography are described and the role of CT is highlighted. PMID:22843760

  6. Malassezia (Pityrosporum) Folliculitis

    PubMed Central

    Rubenstein, Richard M.

    2014-01-01

    Malassezia (Pityrosporum) folliculitis is a fungal acneiform condition commonly misdiagnosed as acne vulgaris. Although often associated with common acne, this condition may persist for years without complete resolution with typical acne medications. Malassezia folliculitis results from overgrowth of yeast present in the normal cutaneous flora. Eruptions may be associated with conditions altering this flora, such as immunosuppression and antibiotic use. The most common presentation is monomorphic papules and pustules, often on the chest, back, posterior arms, and face. Oral antifungals are the most effective treatment and result in rapid improvement. The association with acne vulgaris may require combinations of both antifungal and acne medications. This article reviews and updates readers on this not uncommon, but easily missed, condition. PMID:24688625

  7. Biliary papillomatosis with malignant transformation: A case report and review of the literature

    PubMed Central

    GU, CHICHANG; LIN, YE; JIN, HAOSHENG; JIAN, ZHIXIANG

    2015-01-01

    Biliary papillomatosis is a rare benign tumor that possesses a high potential for malignant transformation, and is frequently misdiagnosed. In the present report, a case of biliary papillomatosis with malignant transformation in a 63-year-old female, with a 19-year history of cholelithiasis, is presented. The patient presented with right epigastric pain and magnetic resonance imaging revealed a diffuse mass in the right liver lobe, which extended through the common bile duct. Definitive preoperative diagnosis was unable to be established; however, following surgical resection of the tumor, a diagnosis of biliary papillomatosis with malignant transformation was confirmed by pathological examination. The patient was followed up seven months later and no recurrence was detected. A supplementary review of previously published literature is additionally presented. PMID:26722332

  8. Melanonychia

    PubMed Central

    Jefferson, Julie; Rich, Phoebe

    2012-01-01

    Melanonychia, or melanin-derived brown-to-black nail pigmentation, is a diagnostic challenge for clinicians. The most serious disease of the nail unit, melanoma, primarily presents with melanonychia. However, melanonychia most often occurs as a result of benign etiologies such as nail matrix melanocytic activation, nail matrix melanocytic hyperplasia, and nail invasion by melanin-producing pathogens. Regrettably, patients with nail apparatus melanoma are often initially misdiagnosed, and due to diagnostic delays of an average of 2 years, melanoma of the nail unit carries a poor prognosis. Having a thorough knowledge of the various causes of melanonychia and using a systematic approach when evaluating brown-to-black nail pigmentation may help prevent misdiagnosis and thereby improve prognosis. PMID:22792094

  9. A rare and unexpected case of retained foetal bone after an unsafe abortion.

    PubMed

    Demirtas, Omer; Terzi, Hasan; Kale, Ahmet; Sanibrahim, Bahar; Guler, Omer Tolga

    2015-10-01

    Unsafe abortion is one of the most neglected healthcare problems in developing countries. One of the rare complications of unsafe abortion is retained foetal bone. Prevalence of disease is around 0.15% among patients undergoing diagnostic hysteroscopy. Patients have no specific symptoms. Case reports have focused on subfertility, abnormal uterine bleeding, lower abdominal pain, abnormal vaginal discharge, dyspareunia, dysmenorrhoea and spontaneous passage of bony fragments. Retained foetal bone fragments may cause acute pelvic inflammatory disease in rare cases regardless of the time interval after abortion. This condition can also present as recurrent vagitinis or endometritis refractory to ampirical antimicrobial treatment. In such cases, foreign body in uterine cavity should be kept in mind. Such patients should primarily be evaluated by ultrasonography which has substantial clinical importance in differential diagnosis of these cases. We present a case of misdiagnosed retained foetal bone complicated with recurrent vaginal discharge and acute pelvic inflammatory disease. PMID:26440846

  10. Headache and the cervical spine: a critical review.

    PubMed

    Pöllmann, W; Keidel, M; Pfaffenrath, V

    1997-12-01

    Headache related to the cervical spine is often misdiagnosed and treated inadequately because of confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as "cervicogenic" merely because of their occipital localization. Cervicogenic headache as described by Sjaastad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiates from occipital to frontal regions. Definition, pathophysiology; differential diagnoses and therapy of cervicogenic headache are demonstrated. Ipsilateral blockades of the C2 root and/or greater occipital nerve allow a differentiation between cervicogenic headache and primary headache syndromes such as migraine or tension-type headache. Neither pharmacological nor surgical or chiropractic procedures lead to a significant improvement or remission of cervicogenic headache. Pains of various anatomical regions possibly join into a common anatomical pathway, then present as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction. PMID:9453267

  11. Detection of Mayaro virus infections during a dengue outbreak in Mato Grosso, Brazil.

    PubMed

    Vieira, Carla Julia da Silva Pessoa; Silva, David José Ferreira da; Barreto, Eriana Serpa; Siqueira, Carlos Eduardo Hassegawa; Colombo, Tatiana Elias; Ozanic, Katia; Schmidt, Diane Johnson; Drumond, Betânia Paiva; Mondini, Adriano; Nogueira, Maurício Lacerda; Bronzoni, Roberta Vieira de Morais

    2015-07-01

    Arboviruses are common agents of human febrile illness worldwide. In dengue-endemic areas illness due to other arboviruses have been misdiagnosed as dengue based only on clinical-epidemiological data. In this study we investigated the presence of Brazilian arboviruses in sera of 200 patients presenting acute febrile illness, during a dengue outbreak in Sinop, MT, Brazil. The results showed that 38 samples were positive to Dengue virus (DENV) type 1, two samples to DENV type 4, and six to Mayaro virus. These results indicate that arboviruses others than DENV are circulating in Sinop and the surrounding region, which are going undiagnosed. In addition, molecular and evolutionary analyses indicate that two MAYV genotypes are co-circulating in Mato Grosso, Brazil. Thus, a strong surveillance program must be implemented to evaluate and monitor the distribution and the true importance of non-dengue arboviruses in the etiology of acute febrile illnesses. PMID:25817238

  12. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos.

    PubMed

    Wang, Qi-Wei; Xu, Wen; Zhu, Ya-Nan; Li, Jin-Yu; Zhang, Li; Yao, Ke

    2012-09-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea, deep anterior chamber, posterior positioning of the iris and lens, iris stroma atrophy, hypoplasia of iris dilator, pupil displacement, large capsular bag, lens subluxation, prematurely cataract and the tendency to retinal detachment. AM, especially when symptoms are mild, is not an easy disease to diagnose. We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea. Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome. Although rare, AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients. PMID:22932204

  13. Zygomycosis in two hematologic cases.

    PubMed

    García-Romero, M T; García-Méndez, J; Arenas, R; Ferrari-Carballo, T; Chanona-Vilchis, J; Cervera-Ceballos, E

    2011-01-01

    Zygomycosis are invasive mould infections, rarely diagnosed in hematologic patients. Most of the cases published are in patients with prolonged neutropenia, along with other risk factors such as the use of prior broad-spectrum antibiotics (including new antifungal agents, such as voriconazole), diabetes mellitus (with or without ketoacidosis), malnutrition, iron overload (with or without the use of deferoxamine). These infections have poor prognosis due to the involvement of vital anatomic structures and late diagnosis. Until recent years, the treatment was based on high doses of amphotericin B plus surgical debridement. Here we present two patients with hematologic diseases (one with leukemia, the second with aplastic anemia) with an impaired immune system and the diagnosis of zygomycosis. The survival of one of them was mainly due to early diagnosis and surgical debridement; unfortunately the second was misdiagnosed as an extensive ecchymosis due to thrombocytopenia and died with CNS involvement. PMID:22567461

  14. Subcutaneous Zygomycosis Due to Basidiobolus ranarum: A Case Report from Maharastra, India

    PubMed Central

    Anand, Mani; Deshmukh, Sanjay D.; Pande, Dilip P.; Naik, Suresh; Ghadage, Dhyaneshwari P.

    2010-01-01

    Entomophthoromycosis is a rare entity. We hereby report a case of entomophthoromycosis in a three-year-old Asian child who presented with a painless, nontender, rapidly increasing large swelling on the thigh of six months duration, which was initially misdiagnosed as a soft tissue tumor and resected. The cause of misleading diagnosis was rapid growth of the lesion in a short duration of time, indicating the possibility of a tumor. Histopathological examination revealed an inflammatory lesion with aseptate fungal hyphae and the characteristic Splendore-Hoeppli phenomenon. Microbiological examination identified the fungus as Basidiobolus ranarum. Complete excision of the lesion followed by antifungal therapy was associated with complete recovery. Entomophthoromycosis should be considered early when children from endemic areas present with unusual, rapid-growing lesions of the subcutaneous region. In order to emphasize tumor-like presentation of zygomycosis, we are presenting this case. PMID:21209703

  15. Zygomycosis in Two Hematologic Cases

    PubMed Central

    García-Romero, M. T.; García-Méndez, J.; Arenas, R.; Ferrari-Carballo, T.; Chanona-Vilchis, J.; Cervera-Ceballos, E.

    2011-01-01

    Zygomycosis are invasive mould infections, rarely diagnosed in hematologic patients. Most of the cases published are in patients with prolonged neutropenia, along with other risk factors such as the use of prior broad-spectrum antibiotics (including new antifungal agents, such as voriconazole), diabetes mellitus (with or without ketoacidosis), malnutrition, iron overload (with or without the use of deferoxamine). These infections have poor prognosis due to the involvement of vital anatomic structures and late diagnosis. Until recent years, the treatment was based on high doses of amphotericin B plus surgical debridement. Here we present two patients with hematologic diseases (one with leukemia, the second with aplastic anemia) with an impaired immune system and the diagnosis of zygomycosis. The survival of one of them was mainly due to early diagnosis and surgical debridement; unfortunately the second was misdiagnosed as an extensive ecchymosis due to thrombocytopenia and died with CNS involvement. PMID:22567461

  16. Pediatric myositis ossificans mimicking osteosarcoma.

    PubMed

    Yamaga, Kensaku; Kobayashi, Eisuke; Kubota, Daisuke; Setsu, Nokitaka; Tanaka, Yuya; Minami, Yusuke; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Kawai, Akira; Chuman, Hirokazu

    2015-10-01

    Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation in soft tissue that most commonly affects young adults, typically following trauma. We report the case of an 11-year-old girl who developed MO mimicking osteosarcoma in her right shoulder. Plain radiography and computed tomography showed poorly defined flocculated densities in the soft tissue and a periosteal reaction along the proximal humerus. On magnetic resonance imaging, the mass displayed an ill-defined margin and inhomogeneous signal change. Histologically, the mass had a pseudosarcomatous appearance. Based on these findings, the patient was initially misdiagnosed with osteosarcoma at another hospital. The diagnosis was difficult because the patient was 11?years old and had no trauma history, with atypical radiographic changes and a predilection for the site of origin for osteosarcomas. We finally made the correct diagnosis of MO by carefully reviewing and reflecting on the pathological differences between stages. PMID:26508182

  17. Primary pancreatic lymphoma: A rare cause of pancreatic mass

    PubMed Central

    BAYSAL, BIROL; KAYAR, YUSUF; ?NCE, ALI TÜZÜN; ARICI, SEMA; TÜRKMEN, ?HSAN; ?ENTÜRK, HAKAN

    2015-01-01

    Primary pancreatic lymphoma (PPL) is a rare entity, most likely to be clinically misdiagnosed as pancreatic cancer. The cure rate of PPL is higher compared with that of pancreatic adenocarcinoma. This is the case report of a 57-year-old male patient who was hospitalized with complaints of abdominal pain, weight loss and jaundice. The radiological evaluation revealed a pancreatic head mass and, following endoscopic ultrasound-guided fine-needle aspiration biopsy, the tumor was diagnosed as diffuse large B-cell lymphoma. The final diagnosis was PPL, and the patient went into remission after receiving three cycles of treatment with rituximab, doxorubicin, cyclophosphamide, vincristine and prednisolone (R-CHOP regimen). Therefore, PPL should be considered in the differential diagnosis of pancreatic masses and its management differs from that of other types of pancreatic tumor.

  18. XPR1: a Gene Linked to Primary Familial Brain Calcification Might Help Explain a Spectrum of Neuropsychiatric Disorders.

    PubMed

    Moura, D A P; Oliveira, J R M

    2015-12-01

    Primary familial brain calcifications (PFBC) compose a rare neurologic condition characterized by a bilateral pattern of hydroxyapatite deposits in basal ganglia, dentate nuclei, and thalamus. PFBC is identified through neuroimaging screenings such as computerized tomography. Patients with PFBC might present a wide variety of neurological symptoms such as mental and motor impairments, often misdiagnosed as Parkinson's disease, schizophrenia, Alzheimer's disease, and migraine. Four genes were confirmed as causative of PFBC: SLC20A2, PDGFB, PDGFRB, and XPR1. Curiously, other studies made occasional links between XPR1 variations or expression changes, in a few neuropsychiatric models. This letter is an assembly on XPR1 variants and expression change pattern data that were published in recent scientific reports, even before the current connection between that gene and brain calcification. PMID:26231937

  19. Murphy's law—if anything can go wrong, it will

    PubMed Central

    Ackermann, Hans-W.; Tiekotter, Kenneth L.

    2012-01-01

    The quality of bacteriophage electron microscopy appears to be on a downward course since the 1980s. This coincides with the introduction of digital electron microscopes and a general lowering of standards, possibly due to the disappearance of several world-class electron microscopists The most important problem seems to be poor contrast. Positive staining is frequently not recognized as an undesirable artifact. Phage parts, bacterial debris, and aberrant or damaged phage particles may be misdiagnosed as bacterial viruses. Digital electron microscopes often seem to be operated without magnification control because this is difficult and inconvenient. In summary, most phage electron microscopy problems may be attributed to human failure. Journals are a last-ditch defense and have a heavy responsibility in selecting competent reviewers and rejecting, or not, unsatisfactory articles. PMID:23050222

  20. Murphy's law-if anything can go wrong, it will: Problems in phage electron microscopy.

    PubMed

    Ackermann, Hans-W; Tiekotter, Kenneth L

    2012-04-01

    The quality of bacteriophage electron microscopy appears to be on a downward course since the 1980s. This coincides with the introduction of digital electron microscopes and a general lowering of standards, possibly due to the disappearance of several world-class electron microscopists The most important problem seems to be poor contrast. Positive staining is frequently not recognized as an undesirable artifact. Phage parts, bacterial debris, and aberrant or damaged phage particles may be misdiagnosed as bacterial viruses. Digital electron microscopes often seem to be operated without magnification control because this is difficult and inconvenient. In summary, most phage electron microscopy problems may be attributed to human failure. Journals are a last-ditch defense and have a heavy responsibility in selecting competent reviewers and rejecting, or not, unsatisfactory articles. PMID:23050222